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ABSTRACT:
Diabetes mellitus (DM) has emerged as a leading global health problem. Diabetes is estimated to affect 425 million adults globally. Majority of diabetic patients take herbal medicines as supplement for the treatment of diabetes. The combined use of herbs and modern synthetic medicine has increased the possibility of pharmacokinetic (PK) and pharmacodynamic (PD) interactions. Momordica charantia (MC) commonly known as bitter melon/bitter gourd, is globally marketed for treatment of diabetes. Many diabetic patients consume MC extract along with antidiabetic drugs for better therapeutic effect with or without knowledge of health care provider.The current study evaluated PKPD herb-interaction of MC extract with glibenclamide (GLB) following oral administration either alone or in combination with MC extract for 28-consequative days. MC extract coadministratioin showed increased plasma exposure of GLB on Day-28 compared to glibenclamide alone treated groups with similar dosing regimen. Glibenclamide upon co-administration with MC extract showed improved pharmacodynamic parameters compared to glibenclamide alone treated groups suggesting synergistic or additive effect. Physician can reduce the glibenclamide dose in diabetic patients if they are taking MC as supplement.
KEYWORDS: Herb-Drug Interaction, Momordica charantia, Glibenclamide, Diabetic rats.
INTRODUCTION:
International Diabetes Federation (IDF) Atlas guideline report mentioned that more than half a billion people are living with diabetes worldwide. In year, 2021, it is estimated that 537 million people are with diabetes and this number predicted to be 643 million in year 2030 and 783 million in year 2045. It is said that worldwide, in the age group of 20 to 79 years, more than 1 in 10 adults is affected with diabetes. In some countries, the prevalence of diabetes is 1 in 5 or even more1 . Diabetes affects the functional capacities of individuals and their quality of life resulting in increase in morbidity and premature mortality2 .
The oral antidiabetic drugs are reported to have certain disadvantages such as drug resistance, adverse effects, and toxicity. For example, sulfonylureas, showed reduced efficacy after 6 years of treatment in almost 44% of the patients. Glucose lowering drugs are not effective in limiting the hyperlipidemia to certain extent3 .
Apart from synthetic modern medicines, many diabetic patients prefer to use plant-based medicines for the treatment of diabetes as complementary and alternative medicine (CAM)4 . Approximately 1200 plants are reported...