Part Used : ราก
Activity : CYTOCHROME P-450 INHIBITION
Solvent/Active Compound : -
Type of experiment : human
Type of animal : -
Type of study : Case report
N(Total) : -
N(Treatment) : -
Route : Oral administration
Dose/Conc.(herb) : Daily ingestion of panax ginseng via energy drinks
Duration : 3 months
Type of interaction : Pharmacokinetics
Interaction with drug : Imatinib*/Glivec/Imatinib mesylate
Dose/Conc.(drug) : 400 mg daily
Remark : The patient's daily ingestion of ginseng led to reduced CYP3A4 activity, which subsequently decreased the metabolism of imatinib. Compromised imatinib metabolism increased its plasma concentration, thus potentiating its hepatotoxic effect.
Note : A 26-year-old man with chronic myelogenous leukemia who had taken imatinib 400 mg daily for 7 years with no complications presented with right upper quadrant pain. Laboratory test results included alanine aminotransferase 1069 U/L, aspartate aminotransferase 481 U/L, alkaline phosphatase 124 IU/L, total bilirubin 1.4 mg/dL, albumin 4.0 g/dL, and international normalized ratio 1.08. Liver biopsy showed acute lobular hepatitis favoring a drug-induced etiology, and a diagnosis of imatinib-induced hepatotoxicity was made. The patient's only lifestyle modification prior to the diagnosis of hepatotoxicity was daily ingestion of Panax ginseng via energy drinks for the past 3 months. Both imatinib and ginseng were discontinued, and the patient was treated with a short course of corticosteroids. Imatinib was later restarted at the same dose with no recurrent elevations in his liver enzyme levels. They propose that the patien's late-onset imatinib-associated hepatotoxicity was due to an interaction between ginseng and imatinib through CYP3A4.
