Page 1158 - Basic _ Clinical Pharmacology ( PDFDrive )

1144 SECTION X Special Topics

Transient depressive symptoms and dysphoria have been reported Barton DL et al: Wisconsin ginseng (Panax quinquefolius) to improve cancer
rarely. Melatonin may affect blood pressure as both increases and related fatigue: A randomized, double-blind trial, N7C2. J Natl Cancer Inst
2013;105:1230.
decreases in blood pressure have been observed. Careful monitor- Birks J, Evans JG: Ginkgo biloba for cognitive impairment and dementia. Cochrane
ing is recommended, particularly in patients initiating melatonin Database Syst Rev 2009;1:CD003120.
therapy while taking antihypertensive medications. Brzezinski A et al: Effects of exogenous melatonin on sleep: A meta-analysis. Sleep
Med Rev 2005;9:41.
Drug Interactions Buck AC: Is there a scientific basis for the therapeutic effects of Serenoa repens in
benign prostatic hyperplasia? Mechanisms of action. J Urol 2004;172:1792.
Melatonin drug interactions have not been formally studied. Butterweck V, Schmidt M: St John’s wort: Role of active compounds for its mecha-
nism of action and efficacy. Wien Med Wochenschr 2007;157:356.
Various studies, however, suggest that melatonin concentrations Capasso A: Antioxidant action and therapeutic efficacy of Allium sativum L.
are altered by a variety of drugs, including nonsteroidal anti- Molecules 2013;18:690.
inflammatory drugs, antidepressants, β-adrenoceptor agonists and Chen X, Hong Y, Zheng P: Efficacy and safety of gingko biloba as an adjunct
antagonists, scopolamine, and sodium valproate. The relevance of therapy in chronic schizophrenia: A systematic review of randomized,
these effects is unknown. Melatonin is metabolized by CYP450 1A2 double-blind, placebo-controlled studies with meta-analysis. Psychiatry Res
2015;228:121.
and may interact with other drugs that either inhibit or induce the Fotino AD, Thompson-Paul AM, Bazzano LA: Effect of coenzyme Q10 supple-
1A2 isoenzyme, including fluvoxamine. Melatonin may decrease mentation on heart failure: A meta-analysis. Am J Clin Nutr 2013;97:268.
prothrombin time and may theoretically decrease the effects of Franco OH et al: Use of plant-based therapies and menopausal symptoms. A
warfarin therapy. A dose-response relationship between the plasma systematic review and meta-analysis. JAMA 2016;315:2554.
concentration of melatonin and coagulation activity has been sug- Fried MW et al: Effect of silymarin (milk thistle) on liver disease in patients with
chronic hepatitis C unsuccessfully treated with interferon therapy. JAMA
gested according to one in vitro analysis. If combination therapy is 2012;308:274.
desired, careful monitoring is recommended especially if melatonin Garcia-Cazarin ML et al: Dietary supplement research portfolio at the NIH, 2009-
is being used on a short-term basis. Melatonin may interact with 2011. J Nutri 2014;144:414.
nifedipine, possibly leading to increased blood pressure and heart Geller AI, et al: Emergency department visits for adverse events related to dietary
supplements. N Engl J Med 2015;373:1531.
rate. The exact mechanism is unknown. Hansen MV, et al: Melatonin for pre- and postoperative anxiety in adults.
Cochrane Database Syst Rev 2015;4:CD009861.
Dosage Heitmann K et al: Pregnancy outcomes after prenatal exposure to echinacea:
The Norwegian mother and child cohort study. Eur J Clin Pharmacol
1. Jet lag—Daily doses of 0.5–5 mg appear to be equally effec- 2016;72:623.
tive for jet lag; however, the 5 mg dose resulted in a faster onset Herxheimer A, Petrie KJ: Melatonin for the prevention and treatment of jet lag.
of sleep and better sleep quality than lower doses. The immediate- Cochrane Database Syst Rev 2002;2:CD001520.
release formulation is preferred and should be given at the desired Ho MJ, Bellusci A, Wright JM: Blood pressure lowering efficacy of coenzyme Q10
for primary hypertension. Cochrane Database Syst Rev 2009;4:CD007435.
sleep time (10 pm–midnight) upon arrival at the new destination Hudson JB: Applications of phytomedicine Echinacea purpurea (Purple
and for 1–3 nights after arrival. A dark room environment is Coneflower) in infectious diseases. J Biomed Biotechnol 2012;2012:769896.
important when taking melatonin and when possible, room lights Izzo AA et al: A critical approach to evaluating clinical efficacy, adverse effects, and
should be turned off. The value of extended-release formulations drug interactions of herbal remedies. Phytother Res 2016;30:4691.
remains unknown, as evidence suggests the short-acting, high- Kang S, Min H: Ginseng, the immunity boost: Effects of Panax ginseng on the
immune system. J Ginseng Res 2012;36:354.
peak effect of the immediate-release formulation to be more effec- Kantor ED et al: Trends in dietary supplement use among US adults from
tive. Exposure to daylight at the new time zone is also important 1999-2012. JAMA 2016;316:1464.
to regulate the sleep-wake cycle. Karsch-Völk M et al: Echinacea for preventing and treating the common cold.
Cochrane Database Syst Rev 2014;2:CD000530.
2. Insomnia—Doses of 0.3–10 mg of the immediate-release Kim HJ, Kim P, Shin CY: A comprehensive review of the therapeutic and
pharmacologic effects of ginseng and ginsenosides in central nervous system.
formulation given orally once nightly have been used. The J Ginseng Res 2013;37:8.
lowest effective dose should be used first and may be repeated in Komishono AM, et al: The effect of ginseng (genus Panax) on blood pressure: A
30 minutes up to a maximum of 10–20 mg. Sustained-release for- systematic review and meta-analysis of randomized controlled clinical trials.
mulations are effective and may be used but, as noted above, may J Hum Hypertension 2016;30:619.
be inferior to immediate-release formulations. Sustained-release Linde K et al: St. John’s wort for major depression. Cochrane Database Syst Rev
2008;4:CD000448.
formulations are also more costly. Liu YR et al: Hypericum perforatum L. preparations for menopause: A meta-analysis
of efficacy and safety. Climacteric 2014;17:325.
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