Key result
Pretreatment with scutellarin increased the AUC0-∞ and Cmax of clopidogrel in male rats.
Why the study?
Does scutellarin affect the metabolism and pharmacokinetics of clopidogrel in rats?
Does scutellarin affect the metabolism and pharmacokinetics of clopidogrel in rats?
Scutellarin significantly inhibits the metabolism of clopidogrel into its active metabolite in rats, suggesting a potential herb-drug interaction that could reduce clopidogrel efficacy.
Answers are grounded in this paper and cite their sources.
Warrants caution for potential reduced clopidogrel efficacy with scutellarin co-use; leaves open validation in human pharmacokinetic studies.
Erigeron breviscapus (Vant.) Hand-Mazz, a traditional Chinese medicine, is often co-prescribed with clopidogrel for the treatment of ischemic vascular diseases. Scutellarin is the representative bioactive flavonoid isolated from this herb. The aim of this study was to explore the effect of scutellarin on the metabolism and pharmacokinetics of clopidogrel. The in vitro studies using rat liver microsomes showed that scutellarin significantly inhibited the metabolism of clopidogrel. The IC50 value was 2.1 µM. Ten male rats were employed to investigate the effect of scutellarin on the pharmacokinetics of clopidogrel in vivo. After pretreatment with scutellarin, there were significant increases in the AUC0-∞ (from 0.9 ± 0.4 to 1.7 ± 0.6 ng/ml h; p <0.05) and Cmax (from 0.4 ± 0.1 to 0.9 ± 0.1 ng/ml; p <0.05) of clopidogrel. The pharmacokinetic data for clopidogrel active metabolite showed significant decreases in AUC0-∞ (18.2 ± 5.6 to 11.4 ± 3.7 ng/ml h; p <0.05) and Cmax (from 8.2 ± 1.2 to 4.3 ± 0.3 ng/ml; p <0.05) after pretreatment with scutellarin. Collectively, the metabolism and pharmacokinetics of clopidogrel were significantly affected by scutellarin. This study indicated that potential herb-drug interaction between scutellarin and clopidogrel should be taken into consideration in clinical use.
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Chen et al. (2014) studied this question. Scutellarin vs. No pretreatment / baseline was evaluated on AUC0-∞ of clopidogrel (p=<0.05). Pretreatment with scutellarin increased the AUC0-∞ and Cmax of clopidogrel in male rats.
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