Therapeutic Potentials and Cytochrome P450-Mediated Interactions Involving Herbal Products Indicated for Diabetes Mellitus.

There has been an increase in the use of herbal products to complement conventional drugs in the treatment of various diseases especially in developing countries. This may be attributable to the relatively cost-effectiveness and ease of accessibility of these products as well as the perception of their safety profiles. However, there are numerous literature reports on herbs altering the pharmacokinetics and pharmacodynamics of other co-administered drugs thereby modulating the therapeutic outcomes. The prevalence of diabetes is on a steady increase worldwide and it is now identified as one of the main threats to human health. The pharmacological mainstay in diabetes management is the use of oral antidiabetic drugs (OADs) as well as insulin for effective hypoglycemic control. But, the literature has documented the utilization of herbal medications for the treatment of diabetes mellitus since time immemorial. Due to the complex phytochemical composition of herbs, when such products are concomitantly administered with OADs, possible alteration of pharmacological effects of these drugs can be expected. It is therefore important that knowledge on specific effects of these herbs and their products on drug metabolizing enzymes are updated and documented so as to ensure optimization of their therapeutic utility. This review highlights herbal products with evidence-based antidiabetic effects and also focuses on the important Cytochrome P450 and consequences of their inhibition or induction. Evidences of beneficial interactions are identified for medical exploitation.