Pharmacokinetic interaction of some antitubercular drugs with caraway: implications in the enhancement of drug bioavailability

Caraway as Important Medicinal Plants in Management of Diseases

Carum carvi or caraway is traditionally used for treatment of indigestion, pneumonia, and as appetizer, galactagogue, and carminative. Essential oil, fixed oil and many other valuable extractive compounds with industrial applications are prepared from caraway. This review article has new deep research on caraway as medicinal plant. For preparing the manuscript, the information was extracted from accessible international databases (Google scholar, PubMed, Science direct, Springer, and Wiley), electronic resources and traditional books by key word of caraway or Carum carvi. The results of traditional studies exhibited that the galactagogue and carminative effects of caraway fruits are superior to other effects. Although, the traditional scholars used it as appetizer, while caraway was the main ingredient of anti-obesity drugs in traditional medicine, which has been confirmed in two modern clinical trials of human studies. Caraway oil in combination with peppermint oil or menthol is used for treatment of functional dyspepsia in clinical studies. Caraway oil topically on abdomen relieves the IBS symptoms in patient. Although, the use of caraway oil is not recommended in adults under 18 years due to insufficient data, but it can topically use as anti-colic and carminative agent in children or infants. The anti-aflatoxigenic, antioxidant and antimicrobial effects of caraway oil along with its reputation as spice help the industries to use it as natural preservatives and antioxidant agents.

Herbal Bioenhancers in Veterinary Phytomedicine

Herbal bioenhancers are active phytomolecules that increase the bioavailability, bioefficacy and biological activity of various drugs when coadministered at low concentrations. These valuable compounds reduce the dose, increase the treatment rate, decrease the treatment duration, drug resistance or related adverse reactions which have economical implications in livestock and pet medicine. Eventhough the concept of herbal bioenhancers are known for years through Ayurvedic medicine, the underlying mechanisms remains unclear. The main mechanisms involved are related to drug absorption (effect on solubility, drug efflux and transport proteins, increased permeability in gastrointestinal system) and drug metabolism (inhibition/induction of drug metabolysing enzymes, thermogenic effect). Due to species specific differences in these mechanisms, corresponding data on human and laboratory animal could not be attributed. As multidrug resistance is a major treat to both human and animal health, within "One Health" concept, efficient therapeutical strategies are encouraged by authorities, where focus on herbal supplements as a vast unexploited field remains to be researched within "Bioenhancement Concept." This review brings insight to mechanims involved in bioenhancing effect, examples of herbal extracts and phytoactive compounds and their potential in the veterinary medicine including different classes of drugs such as antibiotics, anticancerous, antiviral, and antituberculosis.

Effect of Carum carvi, a herbal bioenhancer on pharmacokinetics of antitubercular drugs: A study in healthy human volunteers

Aim and Objectives:

The present study was undertaken in 20 healthy human volunteers to evaluate the effect of a herbal bioenhancer, Carum carvi on pharmacokinetics of rifampicin, isoniazid, and pyrazinamide in fixed dose combination (FDC).

Materials and Methods:

It was a prospective, two-period, open-label, cross-over experiment on 20 healthy human male volunteers. The volunteers were administered a single dose of FDC containing rifampicin (450 mg), isoniazid (300 mg), and pyrazinamide (1000 mg) and after 10 days washout period the same FDC along with C. carvi extract (100 mg) was administered. Blood samples were collected at different time-points and analyzed by high-performance liquid chromatography (HPLC). Detailed pharmacokinetic parameters were calculated, which included C_max, area under curve (AUC), time to reach maximum plasma concentration (T_max), clearance (Cl), volume of distribution (V_d), and half-life (t_½).

Results:

Additions of C. carvi extract lead to increase in plasma levels of rifampicin, isoniazid, and pyrazinamide. The bioavailability indices C_max of rifampicin increased from 4.57 ± 0.19 to 5.95 ± 0.19 (P = 0.000) and AUC increased from 40.11 ± 1.69 to 53.01 ± 1.88 (P = 0.000). Similarly, C_max of isoniazid increased from 2.66 ± 0.16 to 3.62 ± 0.16 (P = 0.000) and AUC from 17.72 ± 0.78 to 22.87 ± 0.94 (P = 0.000). The bioavailability indices of pyrazinamide also revealed an increase in C_max from 18.81 ± 0.79 to 25.06 ± 1.14 (P = 0.000) and AUC from 107.65 ± 4.42 to 137.71 ± 5.92 (P = 0.000), respectively.

Conclusion:

C. carvi acts as a bioenhancer and modifies the kinetics of antitubercular treatment (ATT) favorably.

Cuminum cyminum and Carum carvi: An update

Cuminum cyminum and Carum carvi are the sources of cumin and caraway seeds respectively, which have been used since antiquity for the treatment of various indications in traditional healing systems in wide geographical areas. Cumin and caraway seeds are rich sources of essential oils and have been actively researched for their chemical composition and biological activities. In recent times (especially during the last 3 years) considerable progress has been made regarding validation of their acclaimed medicinal attributes by extensive experimental studies. In this attempt many novel bioactivities have been revealed. This review highlights the significance of cumin and caraway as potential source of diverse natural products and their medicinal applications.