Abstract Title:

Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects.

Abstract Source:

J Ethnopharmacol. 2006 Jul 19;106(3):321-6. Epub 2006 Mar 6. PMID: 20573086

Abstract Author(s):

Mohi Iqbal Mohammed Abdul, Xuemin Jiang, Kenneth M Williams, Richard O Day, Basil D Roufogalis, Winston S Liauw, Hongmei Xu, Anita Matthias, Reginald P Lehmann, Andrew J McLachlan

Article Affiliation:

Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia.


AIMS: This study investigated the pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects.

METHODS: This was an open-label, randomized, three-treatment, cross-over, clinical trial in healthy male subjects (n= 12) of known CYP2C9 and VKORC1 genotype who received a single oral dose of warfarin alone or after 2 weeks of pre-treatment with each herbal medicine at recommended doses. Pharmacodynamic (INR, platelet activity) and pharmacokinetic (warfarin enantiomer concentrations) end points were evaluated.

RESULTS: The apparent clearance of (S)-warfarin (90% CI of ratio; 1.01, 1.18) was significantly higher during concomitant treatment with echinacea but this did not lead to a clinically significant change in INR (90% CI of AUC of INR; 0.91, 1.31). Policosanol did not significantly affect warfarin enantiomer pharmacokinetics or warfarin response. Neither echinacea nor policosanol had a significant effect on platelet aggregation after 2 weeks of pre-treatment with the respective herbal medicines.

CONCLUSION: Echinacea significantly reduced plasma concentrations of S-warfarin. However, neither echinacea nor policosanol significantly affected warfarin pharmacodynamics, platelet aggregation or baseline clotting status in healthy subjects.

Study Type : Human Study

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