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Interaksi Obat-Herbal dengan Agen Hormon dalam Terapi Kanker: Tinjauan Mekanisme dan Implikasi Klinis Zulqifli, Iqbal; Hikmah, Nurul; Shella, Tasya Permata; Azizah, Nabilla Faoziyyah; Apriani, Risa Dwi; Putri, Mukarromah Dita; Hilmi , Indah Laily
Journal of Pharmaceutical and Sciences JPS Volume 8 Nomor 4 (2025)
Publisher : Fakultas Farmasi Universitas Tjut Nyak Dhien

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36490/journal-jps.com.v8i4.1073

Abstract

Hormone therapy is the cornerstone of treatment for hormone-dependent cancers, such as breast and prostate cancer. On the other hand, the high rate of herbal medicine use as complementary treatment in cancer patients has the potential to cause herbal drug interactions (HDIs), which can affect the efficacy and safety of the primary therapy. This study aims to identify and categorize drug-herbal interactions (DHIs) in cancer hormone therapy based on pharmacokinetic mechanisms (including CYP450 enzyme and drug transporter modulation) and pharmacodynamic mechanisms (including hormone receptor and signaling pathway modulation), as well as to conclude their clinical implications. A systematic review was conducted following the PRISMA-ScR guidelines. A literature search was performed in the PubMed, Scopus, ScienceDirect, Frontiers, and Google Scholar databases for relevant in silico, in vitro, and in vivo studies published between 2015 and 2025. Analysis showed that HDI can be categorized into two main groups. First, pharmacokinetic interactions that occur through the modulation of cytochrome P450 (CYP) enzymes and drug transporters, such as the reduction in the bioavailability of tamoxifen by Hedyotis diffusa. Second, pharmacodynamic interactions at hormone receptors, such as the synergistic effect between Boswellia serrata and enzalutamide. The nature of interactions varies greatly, from antagonistic to synergistic, depending on the specific herbal-drug pair. These findings emphasize the importance of clinical vigilance, such as open communication with patients, dose adjustments, therapeutic monitoring, and interprofessional collaboration. These measures are necessary to reduce the risk of HDI and improve the efficacy of cancer therapy.
Evaluasi Bukti dari Uji Klinis tentang Interaksi Antibiotik dan Antasida: Suatu Tinjauan Sistematis Literatur Al Qindy, Wildan Hidayah; Nurdin, Fitri Oktaviani; Khaerunisa, Aulia; Putri, Meisya Diffa Amalia; Hilmi, Indah Laily; Putri, Mukarromah Dita
Journal of Pharmaceutical and Sciences JPS Volume 8 Nomor 4 (2025)
Publisher : Fakultas Farmasi Universitas Tjut Nyak Dhien

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36490/journal-jps.com.v8i4.1093

Abstract

Drug interactions between antibiotics and antacids represent an important clinical issue that can affect therapeutic efficacy and increase the risk of treatment failure. The concurrent use of these drug classes frequently occurs in clinical practice, particularly in patients receiving antibiotic therapy who also present with gastrointestinal complaints. This systematic literature review aims to evaluate the clinical trial evidence regarding antibiotic–antacid interactions, focusing on pharmacokinetic and pharmacodynamic mechanisms, clinical implications, and current research limitations. Relevant articles were identified through PubMed, Google Scholar, and other scientific databases using standardized keywords. Literature selection followed the PRISMA guidelines to ensure the quality and relevance of included studies. The analysis revealed that antacids and proton pump inhibitors (PPIs) can significantly reduce the bioavailability of antibiotics, especially fluoroquinolones and tetracyclines, through chelation with metal ions and by increasing gastric pH, thereby impairing drug absorption. Concomitant use of antibiotics and PPIs was also associated with a higher risk of Clostridioides difficile infection (CDI), particularly in elderly or comorbid patients. Conversely, newer acid-suppressing agents such as vonoprazan demonstrated good efficacy in Helicobacter pylori eradication regimens without compromising antibiotic activity. Despite these findings, most studies were retrospective, with limited sample sizes and specific populations. Therefore, large-scale prospective clinical trials are needed to strengthen the evidence base. A comprehensive understanding of antibiotic–antacid interactions is essential to support rational, safe, and effective prescribing practices in clinical settings.
Keamanan Kontrimoksazol pada Wanita Hamil: Safety of Cotrimoxazole in Pregnant Woman: a Narrative Review Putri, Mukarromah Dita; Yasin, Nanang Munif; Puspitasari, Ika
Jurnal Surya Medika (JSM) Vol. 10 No. 2 (2024): Jurnal Surya Medika (JSM)
Publisher : Institute for Research and Community Services Universitas Muhammadiyah Palangkaraya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33084/jsm.v10i2.5816

Abstract

Latar Belakang : Pada wanita hamil, kondisi imunitas dapat berubah yang dipengaruhi oleh hormon kehamilan. Fluktuasi hormonal dan perubahan pada sistem kekebalan tubuh adalah penyebab utama pada peningkatan kerentanan tubuh terhadap infeksi. Kotrimoksazol adalah antibiotik yang terdiri dari trimethoprim dan sulfametoksazol yang bisa digunakan untuk mengatasi infeksi saluran kemih, selulitis, demam tifoid pada anak, disentri basiler dan infeksi kolera. Secara luas kotrimoksazol banyak digunakan sebagai profilaksis untuk pasien yang terinfeksi HIV untuk melindungi dari infeksi oportunistik. Tujuan: Penelusuran dan pembahasan artikel ini bertujuan untuk memaparkan keamanan kotrimoksazol pada wanita hamil. Metode: Artikel ini merupakan tinjauan naratif. Penelusuran artikel dilakukan secara elektronik melalui database BioMed Central, PubMed, ScienceDirect, Scopus, Clinical Key, dan Springer Link yang diterbitkan tahun 2003-2023 dengan artikel yang masuk kriteria inklusi sebanyak 4 artikel. Hasil: Terdapat 4 artikel yang membahas keamanan penggunaan kotrimoksazol pada kehamilan yang memenuhi kriteria inklusi. Kesimpulan: Kotrimoksazol dapat digunakan pada masa kehamilan dengan memberikan terapi tambahan asam folat untuk mencegah kejadian tidak diinginkan pada janin.