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All Journal IDJP (Indonesian Journal of Pharmaceutics)
Amelia Soyata
Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Universitas Padjajaran, Sumedang, Indonesia

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Interaction of Warfarin with Herbs Based on Pharmacokinetic and Pharmacodynamic Parameters Amelia Soyata; Aliya Nur Hasanah; Taofik Rusdiana
Indonesian Journal of Pharmaceutics Vol 2, Issue 2, May - August, 2020
Publisher : Universitas Padjadjaran (Unpad)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/idjp.v2i2.27289

Abstract

Warfarin is an oral anticoagulant that has been widely used and has strong efficacy, but the use of warfarin is still a concern because of its narrow therapeutic index which cause interactions when co-administration with drugs, herbs or food. This interaction can affect the pharmacokinetics and pharmacodynamics of warfarin and the most fatal effect from warfarin interactions is bleeding. In this review article data on warfarin-herbs interactions were collected based on pharmacokinetic parameters (AUC0-∞, Cmax, T1/2, Cl/F, and V/F), while pharmacodynamic parameters (International normalized ratio (INR), platelet aggregation, AUC INR and Protombine Time). As a result some herbs had significant interactions with warfarin. Herbs that affect warfarin pharmacokinetic were Danshen gegen, echinacea, St. John's wort and caffeine and herbs that affect pharmacodynamic were policosanol, Ginkgo biloba, cranberry, St. John's wort, ginseng, pomegranate, Psidium guajava and curcumin, so co-administration warfarin with herbs need to be considered.Keywords: Warfarin, Interactions, Herbs, Pharmacokinetics, Pharmacodynamics
Co-Authors Aliya Nur Hasanah Taofik Rusdiana