. 2016 Aug 10;7:248. doi: 10.3389/fphar.2016.00248

Table 4.

Map of the potential pharmacokinetic interaction between the prescribed drugs and the herbal medicines used by the patients.

Prescription drug	Pharmacokinetic effects (Sweetman, 2011; Ezuruike and Prieto, 2014)
	Intestinal absorption	Efflux	Cytochromes								Liver toxicity
		P-gp	1A2	2B6	2C8	2C9	2C19	2D6	2E1	3A4	AST/ALT
Glibenclamide		^a, ^b VA, MI				^a				^a MI, PA
Metformin	AE	B
Pioglitazone										^a MI, PA	^d OG, PN, TC
Sitagliptin		^a VA, MI
Vidagliptin		^a VA
Amlodipine		^b, ^c
Indapamide										^a MI, PA
Losartan						^a				^a MI, PA
Nifedipine			^b MI						^b	^a MI, PA
Atorvastatin		^a, ^b VA, MI								^a MI, PA	^d OG, PN,TC
Clopidogrel				^a	^a		^a			^a MI, PA
Tramadol				^a				^a		^a MI, PA

Key: For the prescription drugs,

is an identified substrate of the enzyme/protein;

inhibits enzyme/protein activity;

enhances enzyme/protein activity;

increases plasma levels of transaminases. The two letter codes denotes a herb which also affects the same PK target of the prescription drug: MI, Mangifera indica (Mango); VA, Vernonia amygdalina (Bitter leaf); OG, Ocimum gratissimum L. (Scent leaf); PN, Picralima nitida (Akuamma plant); AE, Abelmoschus esculentus (Okro); PA, Persea americana (Avocado pear); TC, Terminalia catappa (Tropical almond).