Significant Interactions

There are reports of baical flavonoids interacting with P450 enzymes. Baical flavonoids inhibit hepatic CYP1A2 (Kim etal 2002) and CYP2E1 expression (Jang etal 2003). Theoretically, inhibition of CYP1A2 and CYP2E1 may affect certain medical drugs metabolised by these P450 enzymes. There are, however, no clinical reports of such herb-drug interactions.

Sho-saiko-to during interferon therapy Sho-saiko-to, as well as interferon, is Vi/ used for the treatment of chronic hepatitis. There have been reports of acute pneumonitis due to a possible interferon-herb interaction. Pneumonitis, also called extrinsic allergic alveolitis, is a complex syndrome caused by sensitisation to an allergen. The mechanism of the Sho-saiko-to-interferon interaction seems to be due to an allergic-immunological mechanism rather than direct toxicity (Ishizaki et al 1996) —contraindicated.

Cyclosporins A decoction of S. baicalensis has been reported to significantly decrease plasma levels of cyclosporine in rats. The co-administration of these two substances should be avoided until further research is available (Lai et al 2004). Warfarin/anticoagulants Increased risk of bleeding is theoretically possible—use with caution.

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