著者

石原 三也 本間 真人 久能 英子 渡邊 真知子 幸田 幸直

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.122, no.9, pp.695-701, 2002-09-01 (Released:2003-02-18)

参考文献数

51

被引用文献数

22 19

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The intestinal bacteria, Eubacterium sp. and Bifidobacterium sp., participate in the metabolism of active kampo-ingredients, glycyrrhizin (GL), sennoside (SEN) and baicalin (BL). Since antibiotics and bacterial preparations, Bifidobacterium longum (LAC-B®), Clostridium butyricum (MIYA-BM®), and Streptococcus faecalis (BIOFERMIN®), affect the bacterial population in intestinal bacterial flora, metabolism of the active kampo-ingredients in the bacterial flora may be altered by their combined administration. We investigated 1199 prescriptions including kampo-medicines for 308 patients. Combination use of kampo-medicines with antibiotics and bacterial preparations occurred with 7% and 10% of the kampo-prescription, respectively. Most antibiotics have activity against intestinal bacteria, except that cephems and macrolides are not active against to E. coli. This means that antibiotics may lower the metabolism of GL, SEN and BL when administered in combination. On the other hand, it is also highly possible that bacterial preparations increase the number of Eubacterium sp. and Bifidobacterium sp., resulting in enhanced metabolism of GL and SEN when they are used concomitantly with kampo-medicines. The present results suggested that the drug interactions of kampo-medicines with antibiotics and bacterial preparations should be confirmed in clinical studies.

著者

本間 真人 石原 三也 千 文 幸田 幸直

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.126, no.10, pp.973-978, 2006 (Released:2006-10-01)

参考文献数

33

被引用文献数

19 32

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Typical adverse effects of Shakuyaku-kanzo-To (SKT), an herbal medicine containing licorice, is a licorice-induced pseudoaldosteronism with hypokalemia and hypertension. The risk factors for this side effect are still unclear. To identify the risk factors, we surveyed 37 cases of licorice-induced pseudoaldosteronism in the literature and serum potassium levels in our patients receiving SKT and Shosaiko-To (SST), which contain 6 g and 1.5 g of licorice in the daily dose, respectively. In the case report survey, pseudoaldosteronism developed a median 35 (range 2—231) days after the administration of SKT, which is shorter than after SST (450, range 150—2190 days) and other licorice products including glycyrrhizin (210, range 14—730 days). A significant correlation was observed between the glycyrrhizin contents in the licorice preparations and the dosing periods for developing pseudoaldosteronism (r=-0.700, p < 0.01). A negative correlation was also observed between serum potassium level and dosing period for SKT, but not for SST. The difference in age (65.3 ± 11.6 vs. 57.2 ± 17.3 y) and dosing period (57.3 ± 66.3 vs. 19.0 ± 24.3 days) between the patients with and without hypokalemia after the administration of SKT was statistically significant (p < 0.05). The occurrence rate of hypokalemia including pseudoaldosteronism was around 80% with SKT administration for more than 30 days for patients exceeding 60 years old. It was suggested that patient age (>60 y) and dosing period of SKT (>30 days) might be risk factors for developing pseudoaldosteronism or hypokalemia as well as coadministration of drugs inducing hypokalemia.