臨床検査53巻8号

2009年08月発行

今月の主題 漢方薬・生薬と臨床検査 各論 〈相互作用〉

生薬や食品と西洋薬の相互作用解析

著者： 三木晶子¹ 澤田康文¹

所属機関： ¹東京大学大学院薬学系研究科医薬品情報学講座

ページ範囲：P.917 - P.925

　薬だけではなく，食べ物あるいは飲料物・嗜好品においても，体に入ればそれぞれの成分が生体のある構成成分を介して何らかの相互作用を起こす危険性を秘めている．本稿では，主に臨床検査の場面で重要だと思われるワルファリン治療下における抗凝固能(international normalized ratio；INRなど)やTDM対象になっている薬剤の血中濃度に影響を与える生薬(ハーブを含む)や食品のうち重要なものを取り上げた．

参考文献

1) Daugherty NE, Smith KM：Dietary supplement and selected food interactions with warfarin. Orthopedics　29：309-314, 2006

2) Chan TY：Interaction between warfarin and danshen (Salvia miltiorrhiza). Ann Pharmacother　35：501-504, 2001

3) Page RL 2nd, Lawrence JD：Potentiation of warfarin by dong quai. Pharmacotherapy.　19：870-876, 1999

4) Lam AY, Elmer GW, Mohutsky MA：Possible interaction between warfarin and Lycium barbarum L. Ann Pharmacother　35：1199-1201, 2001

5) Davis NB, Nahlik L, Vogelzang NJ：Does PC-SPEs interact with warfarin? J Urol　167：1793, 2002

6) Matthews MK Jr：A Association of Ginkgo biloba with intracerebral hemorrhage. Neurology　50：1933-1934, 1998

7) Engelsen J, Nielsen JD, Hansen KF：Effect of Coenzyme Q10 and Ginkgo biloba on warfarin dosage in patients on long-term warfarin treatment. A randomized, double-blind, placebo-controlled cross-over trial. Ugeskr Laeger　165：1868-1871, 2003

8) Janetzky K, Morreale AP：Probable interaction between warfarin and ginseng. Am J Health Syst Pharm　54：692-693, 1997

9) Jiang X, Williams KM, Liauw WS, et al：Effect of St John's wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 57：592-599, 2004 Erratum in：Br J Clin Pharmacol　58：102, 2004

10) Wong AL, Chan TY：Interaction between warfarin and the herbal product quilinggao. Ann Pharmacother　37：836-838, 2003.

11) 澤田康文：薬と食の相互作用〈下巻〉薬と食・嗜好品の出会いで起こる治療の失敗，医薬ジャーナル社，pp6-47, 2005

12) Johne A, Brockmöller J, Bauer S, et al：Pharmacokinetic interaction of digoxin with an herbal extract from St John's wort (Hypericum perforatum). Clin Pharmacol Ther　66：338-345, 1999

13) Fushimi R, Amino N：Digoxin immunoassay and Chinese medicine. Clin Chem　39：2203-2204, 1993

14) Dasgupta A：Herbal supplements and therapeutic drug monitoring：focus on digoxin immunoassays and interactions with St. John's wort. Ther Drug Monit　30：212-217, 2008

15) Harada T, Ohtaki E, Misu K, et al：Congestive heart failure caused by digitalis toxicity in an elderly man taking a licorice-containing chinese herbal laxative. Cardiology　98：218, 2002

16) Ruschitzka F, Meier PJ, Turina M, et al：Acute heart transplant rejection due to Saint John's wort. Lancet　355：548-549, 2000

17) Barone GW, Gurley BJ, Ketel BL, et al：Drug interaction between St. John's wort and cyclosporine. Ann Pharmacother　34：1013-1016, 2000

18) Mai I, Krüger H, Budde K, et al：Hazardous pharmacokinetic interaction of Saint John's wort (Hypericum perforatum) with the immunosuppressant cyclosporin. Int J Clin Pharmacol Ther　38：500-502, 2000

19) Barone GW, Gurley BJ, Ketel BL, et al：Herbal supplements：a potential for drug interactions in transplant recipients. Transplantation　71：239-241, 2001

20) Karliova M, Treichel U, Malagò M, et al：Interaction of Hypericum perforatum (St. John's wort) with cyclosporin A metabolism in a patient after liver transplantation. J Hepatol　33：853-855, 2000

21) Ahmed SM, Banner NR, Dubrey SW：Low cyclosporin-A level due to Saint-John's-wort in heart transplant patients. J Heart Lung Transplant　20：795, 2001

22) Beer AM, Ostermann T：Cyclosporine interaction with St John's wort (Hypericum perforatum) increases the risk of graft rejection and causes a raise of the daily medication costs. Medizinische Klinik　96：480-484, 2001

23) Moschella C, Jaber BL：Interaction between cyclosporine and Hypericum perforatum (St. John's wort) after organ transplantation. Am J Kidney Dis　38：1105-1107, 2001

24) Breidenbach T, Kliem V, Burg M, et al：Profound drop of cyclosporin A whole blood trough levels caused by St. John's wort (Hypericum perforatum). Transplantation　69：2229-2230, 2000

25) Bolley R, Zülke C, Kammerl M, et al：Tacrolimus-induced nephrotoxicity unmasked by induction of the CYP3A4 system with St John's wort. Transplantation　73：1009, 2002

26) Nebel A, Schneider BJ, Baker RK, et al：Potential metabolic interaction between St. John's wort and theophylline. Ann Pharmacother　33：502, 1999

27) Buckley MS, Goff AD, Knapp WE：Fish oil interaction with warfarin. Ann Pharmacother　38：50-52, 2004

28) Monterrey-Rodríguez J：Interaction between warfarin and mango fruit. Ann Pharmacother　36：940-941, 2002

29) Suvarna R, Pirmohamed M, Henderson L：Possible interaction between warfarin and cranberry juice. BMJ　327：1454, 2003

30) Taylor JR, Wilt VM：Probable antagonism of warfarin by green tea. Ann Pharmacother　33：426-428, 1999

31) Blickstein D, Shaklai M, Inbal A：Warfarin antagonism by avocado. Lancet　337：914-915, 1991

32) Bartle WR, Madorin P, Ferland G：Seaweed, vitamin K, and warfarin. Am J Health Syst Pharm 2001

33) Knudsen JF, Sokol GH：Potential glucosamine-warfarin interaction resulting in increased international normalized ratio：case report and review of the literature and MedWatch database. Pharmacotherapy　28：540-548, 2008

34) Edwards DJ, Fitzsimmons ME, Schuetz EG, et al：6', 7'-Dihydroxybergamottin in grapefruit juice and Seville orange juice：effects on cyclosporine disposition, enterocyte CYP3A4, and P-glycoprotein. Clin Pharmacol Ther　65：237-244, 1999

35) Westveer MK, et al：(学会要旨) Ann. Meet. Am. Soc. Transplant. Physicians　202：P-115, 1996

36) Peynaud D, Charpiat B, Vial T, et al：Tacrolimus severe overdosage after intake of masked grapefruit in orange marmalade. Eur J Clin Pharmacol　63：721-722, 2007

37) Prasad GV, Wong T, Meliton G, et al：Rhabdomyolysis due to red yeast rice(Monascus purpureus)in a renal transplant recipient. Transplantation　74：1200-1201, 2002

38) Sato J, Nakata H, Owada E, et al：Influence of usual intake of dietary caffeine on single-dose kinetics of theophylline in healthy human subjects. Eur J Clin Pharmacol　44：295-298, 1993

39) Jonkman JH, Sollie FA, Sauter R, et al：The influence of caffeine on the steady-state pharmacokinetics of theophylline. Clin Pharmacol Ther　49：248-255, 1991