Prednisolone Glycyrrhizin

Similar to the challenges outlined in Chapter 2, the fact that most Chinese herbal medicines are complex mixtures of multiple active constituents further complicates the interpretation of study data, as well as extrapolation to other botanical products. Japanese Kampo (traditional Chinese herbal mixtures) prescriptions have been used for many years to treat different chronic conditions and are presently manufactured in Japan as drugs with standardized quantities and qualities of constituents. Homma et al. (51) evaluated the effect of three commonly used Japanese Kampo prescriptions, Sho-saiko-to (Xiao Chai Hu Tang), Saiboku-to, and Sairei-to, on prednisolone pharmacokinetics in humans. All three botanical prescriptions contain glycyrrhizin, a strong inhibitor of 11-p-hydroxysteroid dehydrogenase. Chen et al. (52) had shown that glycyrrhizin decreased plasma clearance and increased AUC and concentration of prednisolone. 

Chen ME, Shimada F, Kato H, Yano S, Kanaoka M. Effect of oral administration of glycyrrhizin on the pharmacokinetics of prednisolone. Endocrinol Jpn 1991 38 167-174. 

Prednisolone Glycyrrhizin decreases plasma clearance, 11 P-dehydrogenase converts endogenous cortisol... 

Black cohosh 2. Geum chiloense 3. Liquorice 1. Cisplatin 2. Azathioprine 3. Cidosporin 4. Prednisolone t cytotoxic properties. Geum t plasma cidosporin levels 6-8-fold Unknown mechanism (black cohosh) Inhibits metabolizing enzymes. Glycyrrhizin present in liquorice inhibits the metabolizing enzyme of prednisolone, 11 beta-hydroxysteroid dehydrogenase, which converts the active metabolite to an inactive form. i clearance of prednisolone in healthy individuals Be aware. Advice is to avoid echinacea with immunosuppressants... 

A study in 6 healthy subjects found that after taking 50-mg oral doses of glycyrrhizin every 8 hours for 4 doses, followed by a bolus injection of prednisolone hemisuccinate 96 micrograms/kg, the AUC of total prednisolone was increased by 50% and the AUC of free prednisolone was increased by 55%. This confirms the findings of two previous studies in which the glycyrrhizin was given orally, or by intravenous infusion, and one study where the route of administration is not clear. ... 

The probable reason for this reaction is that glycyrrhizin inhibits the metabolism of prednisolone by the liver. In one of the studies it was also found that glycyrrhizin increased the effects of prednisolone in some patients with rheumatoid arthritis and polyarteritis nodosa. ... 

OjimaM, SatohK, Gomibuchi T, ItohN, KinS, Fukuchi S, Miyachi Y. The inhibitory effects of glycyrrhizin and glycyrrhetinic acid on the metabolism of cortisol and prednisolone —in vivo and in vitro stupes. Nippon Naibunpi Gdkkai Zasshi (1990) 66,584-96. 

Coadministration of glycyrrhizin (50 mg orally) and prednisolone (0.096 mg/kg intravenously) significantly decreased the clearance of and increased the plasma concentrations of prednisolone (Cheng et al. 2004). 

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