The effects of oral administration of Cola nitida on the pharmacokinetic profile of metoclopramide in rabbits

Herbal medicines are widely perceived as natural and safe remedies. However, their concomitant use with prescribed drugs is a common practice, often undertaken without full awareness of the potential risks and frequently without medical supervision. This practice introduces a tangible risk of herb‐drug interactions, which can manifest as a spectrum of consequences, ranging from acute, self‐limited reactions to unpredictable and potentially lethal scenarios. This review offers a comprehensive overview of herb‐drug interactions, with a specific focus on medications targeting the Central and Peripheral Nervous Systems. Our work draws upon a broad range of evidence, encompassing preclinical data, animal studies, and clinical case reports. We delve into the intricate pharmacodynamics and pharmacokinetics underpinning each interaction, elucidating the mechanisms through which these interactions occur. One pressing issue that emerges from this analysis is the need for updated guidelines and sustained pharmacovigilance efforts. The topic of herb‐drug interactions often escapes the attention of both consumers and healthcare professionals. To ensure patient safety and informed decision‐making, it is imperative that we address this knowledge gap and establish a framework for continued monitoring and education. In conclusion, the use of herbal remedies alongside conventional medications is a practice replete with potential hazards. This review not only underscores the real and significant risks associated with herb‐drug interactions but also underscores the necessity for greater awareness, research, and vigilant oversight in this often‐overlooked domain of healthcare.

P-glycoprotein (P-gp) is a transporter protein that is come under the ATP binding cassette family of proteins. It is situated on the surface of the intestine epithelium, where P-gp substrate binds to the transporter and is pumped into the intestine lumen by the ATP-driven energy-dependent process. In this review, we summarize the role of the P-gp efflux transporter situated on the intestine, the clinical importance of P-gp related drug interactions, and approaches to minimize the effect of P-gp in drug transport. This review also focuses on the impact of P-gp on the bioavailability of the orally administered drug. Many drug's oral bioavailabilities can improve by concomitant use of P-gp inhibitors. Multidrug resistance are reduced by using some naturally occurring compounds obtained from plants and several synthetic P-gp inhibitors. Formulation strategies, one of the most important approaches to mimic the P-gp transporter's action, finally enhancing the oral bioavailability of the drug by inhibiting its P-gp efflux. Vitamin E TPGS, Gelucire 44/14 and other pharmaceutical/formulation excipients inhibit the P-gp efflux. A prodrug approach might be a useful strategy to overcome drug resistance.Prodrug helps to enhance the solubility or alter the pharmacokinetic properties but does not diminish the pharmacological action.

The purpose of this mini-review was to summarize and update knowledge on the phytochemistry, pharmacology, and toxicity of <i>Cola nitida</i>, with the view of providing baseline data for herbal drug formulation. In January 2021, a non-exhaustive online search of relevant articles was carried out on the phytochemistry, pharmacology, and toxicology of <i>C. nitida</i> from scientifically well-established databases such as Science Direct, PubMed, Web of Science, Scopus, Google Scholar, and SciELO. The plant's scientific name as well as phytochemistry, pharmacology, pharmacognosy, bioactivity and toxicology were used as keywords. The chemical structures of the compounds isolated from this plant were drawn using ChemBioDraw Ultra 12.0 software. A literature survey has revealed that <i>C. nitida</i> is highly appreciated by African populations in various cultures, especially in West Africa. Phytochemical analyses showed that <i>C. nitida</i> contains interesting compounds like catechin, caffeine, epicatechin, polyphenols, alkaloids, tannins, saponins, bromelain, cardenolides, proanthocyanidins, triterpenes, glycosides, flavonoids, anthraquinones, steroids, anthocyanins, glycosides, alkaloids, etc. The presence of these phyto-compounds in the investigated plant species justifies its used as an antimicrobial, anti-malarial, anti-inflammatory, anti-diabetic, anti-coagulant agent. Thus, <i>C. nitida</i> could be used as a raw material for manufacturing efficient medication against various diseases, including sickle cell disease.