ArticleMolecular nutrition & food research2008
Clinical assessment of CYP2D6-mediated herb-drug interactions in humans: effects of milk thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea.
Article in Molecular nutrition & food research, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
56 citing papers in PubMed, 3 syntheses or guidelines pooled it, 164 citations in OpenAlex.
- Adverse effects of plant food supplements and botanical preparations: a systematic review with critical evaluation of causality.British journal of clinical pharmacology · 2015Pooled it
- Adverse events associated with complementary and alternative medicine use in ovarian cancer patients.Integrative cancer therapies · 2013Pooled it
- Interactions between herbal medicines and prescribed drugs: an updated systematic review.Drugs · 2009Pooled it
- Sex-Dependent Effects of CYP2D6 on the Pharmacokinetics of Berberine in Humans.Clinical pharmacology and therapeutics · 2025Trial
- Assessing Transporter-Mediated Natural Product-Drug Interactions Via In vitro-In Vivo Extrapolation: Clinical Evaluation With a Probe Cocktail.Clinical pharmacology and therapeutics · 2021Trial
- The effects of milk thistle (Silybum marianum) on human cytochrome P450 activity.Drug metabolism and disposition: the biological fate of chemicals · 2014Trial
- Effect of milk thistle on the pharmacokinetics of darunavir-ritonavir in HIV-infected patients.Antimicrobial agents and chemotherapy · 2012Trial
- Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Emerging Patterns in Dietary Supplement Use Among US Adults, 1999-2023.JAMA network open · 2026Article
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- Review of black cohosh-induced toxicity and adverse clinical effects.Journal of environmental science and health. Part C, Toxicology and carcinogenesis · 2025Review
- Anti-Emetics in Children Receiving Chemotherapy for Solid Tumors and Leukemia: Pharmacology and Optimization of Therapy for Nausea and Vomiting.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Acetaminophen: A Liver Killer or Thriller.Cureus · 2023Review
- The Role of Diet as a Modulator of the Inflammatory Process in the Neurological Diseases.Nutrients · 2023Review
- Evaluation of Concomitant Use of Anticancer Drugs and Herbal Products: From Interactions to Synergic Activity.Cancers · 2022Article
- Controversial Interactions of Tacrolimus with Dietary Supplements, Herbs and Food.Pharmaceutics · 2022Review
- In vitro inhibition of carboxylesterase 1 by Kava (Piper methysticum) Kavalactones.Chemico-biological interactions · 2022Article
- Physiologically based pharmacokinetic model predictions of natural product-drug interactions between goldenseal, berberine, imatinib and bosutinib.European journal of clinical pharmacology · 2022Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
Cytochrome P450 2D6 (CYP2D6), an important CYP isoform with regard to drug-drug interactions, accounts for the metabolism of approximately 30% of all medications. To date, few studies have assessed the effects of botanical supplementation on human CYP2D6 activity in vivo. Six botanical extracts were evaluated in three separate studies (two extracts per study), each incorporating 16 healthy volunteers (eight females). Subjects were randomized to receive a standardized botanical extract for 14 days on separate occasions. A 30-day washout period was interposed between each supplementation phase. In study 1, subjects received milk thistle (Silybum marianum) and black cohosh (Cimicifuga racemosa). In study 2, kava kava (Piper methysticum) and goldenseal (Hydrastis canadensis) extracts were administered, and in study 3 subjects received St. John's wort (Hypericum perforatum) and Echinacea (Echinacea purpurea). The CYP2D6 substrate, debrisoquine (5 mg), was administered before and at the end of supplementation. Pre- and post-supplementation phenotypic trait measurements were determined for CYP2D6 using 8-h debrisoquine urinary recovery ratios (DURR). Comparisons of pre- and post-supplementation DURR revealed significant inhibition (approximately 50%) of CYP2D6 activity for goldenseal, but not for the other extracts. Accordingly, adverse herb-drug interactions may result with concomitant ingestion of goldenseal supplements and drugs that are CYP2D6 substrates.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.