A Review: The pharmacokinetics and pharmacodynamics of metformin-herb interactions
Abstract
Background: Diabetes mellitus is a metabolic disorder characterized by hyperglycemia. Metformin is the
first-line therapy for type-2 diabetes mellitus. The combination of synthetic drugs with herbs was reported
to be superior and popular compared to monotherapy. However, drug-herb interactions can have both
beneficial and detrimental effects.
Objective: This review was aimed to identify the interactions that occur between the antidiabetic drug
metformin and herbs.
Methods: Literature search was done through ScienceDirect, ResearchGate, Pharmaceutics, and Genes by
MDPI databases using the keywords metformin, antidiabetic, herb-drug, interaction, pharmacology,
combination, pharmacokinetics, and pharmacodynamics.
Results: The combination of metformin and such herbs as Korean ginseng (Panax ginseng), Lonicera
japonica, Houttuynia cordata, mulberry (Morus alba), banana (Musa sapientum), Momordica charantia,
coconut (Cocos nucifera), and Scutellaria baicalensis showed pharmacokinetic interactions in the form of
increasing plasma metformin uptake mediated by MATE1 inhibition and increased OCT1, as well as hOCT2
inhibition which caused decreased metformin uptake in the kidneys. The pharmacodynamic interactions
showed a direct effect, both additive and synergistic effects, in reducing blood glucose levels.
Conclusion: Consuming metformin with herbs shows the potential for drug interactions in terms of both
pharmacokinetics and pharmacodynamics