One is a Chinese med article, you can use google web translate. This medicine can be bought in China, it’s very cheap.
Google AI Overview:
Wuzhi Soft Capsule (WZC), an herbal preparation from Schisandra sphenanthera, acts as an inhibitor of the CYP3A4 enzyme, significantly affecting the metabolism and blood concentrations of other drugs metabolized by this pathway. [1, 2]
Interaction with CYP3A4
The primary active ingredients in Wuzhi capsule, such as schisandrin B (SZB) and schisantherin A, inhibit the activity of cytochrome P450 3A4 (CYP3A4) and CYP3A5 enzymes. [2, 3]
This inhibition can occur through both reversible and time-dependent mechanisms, leading to a reduced metabolic rate of co-administered drugs that are substrates for CYP3A4. The result is an increase in the concentration and exposure (AUC - area under the curve) of those other drugs in the bloodstream. [1, 2, 3, 4, 5]
Clinical Significance: Drug Interactions
WZC is widely co-prescribed in traditional Chinese medicine to protect liver function or to achieve more efficient drug levels, particularly with immunosuppressants like tacrolimus (FK506).
- Increased Drug Concentration: Co-administration of WZC can significantly increase the blood concentration of tacrolimus (a CYP3A4 substrate), allowing for lower doses of tacrolimus to be used while achieving the desired therapeutic effect.
- Genotype Considerations: The magnitude of this interaction is especially significant in patients who are “CYP3A5 expressers” (due to genetic polymorphism), suggesting a personalized medicine approach may be beneficial.
- Other Potential Interactions: WZC has also been shown to affect the pharmacokinetics of other drugs like regorafenib and cyclophosphamide, which are also metabolized by CYP3A4. [1, 6, 7, 8, 9]
Due to the potential for significant herb-drug interactions, the combination of WZC with other medications, especially those with a narrow therapeutic index like tacrolimus, requires careful clinical monitoring and dose adjustment. [1, 4, 10, 11, 12]
AI responses may include mistakes.
[1] https://analyticalsciencejournals.onlinelibrary.wiley.com/doi/10.1002/jssc.202300923
[2] Controversial Interactions of Tacrolimus with Dietary Supplements, Herbs and Food - PMC
[3] Examination of the Impact of CYP3A4/5 on Drug–Drug Interaction between Schizandrol A/Schizandrol B and Tacrolimus (FK-506): A Physiologically Based Pharmacokinetic Modeling Approach - PMC
[4] https://journals.lww.com/drug-monitoring/fulltext/2024/02000/effects_of_wuzhi_capsule_on_whole_blood_tacrolimus.4.aspx
[5] https://www.sciencedirect.com/science/article/abs/pii/S0090955624097496
[6] Effects and safety evaluation of Wuzhi Capsules combined with tacrolimus for the treatment of kidney transplantation recipients - PubMed
[7] Beneficial effects of Wuzhi Capsule on tacrolimus blood concentrations in liver transplant patients with different donor-recipient CYP3A5 genotypes - PubMed
[8] The Influence of Wuzhi Capsule on the Pharmacokinetics of Cyclophosphamide | Bentham Science
[9] https://www.researchgate.net/publication/6325200_Effects_of_Schisandra_sphenanthera_extract_on_the_pharmacokinetics_of_tacrolimus_in_healthy_volunteers
[10] https://onlinelibrary.wiley.com/doi/full/10.1111/jcpt.13493
[11] https://www.pdr.net/drug-summary/Envarsus-XR-tacrolimus-3779
[12] https://journals.sagepub.com/doi/10.1177/09731296231158703
