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Aristolochia spp.



Interactions

Aristolochia/Drug Interactions:
  • AntibioticsAntibiotics: Based on laboratory tests, Aristolochia spp. leaves, bark, and rhizomes may have antibacterial activity (46; 47; 6; 6; 44; 48; 7; 49).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Aristolochia spp. roots and stems may have antiplatelet properties (55; 56).
  • AntifungalsAntifungals: Based on laboratory studies, Aristolochia may have antimicrobial activity (50; 4; 4; 51).
  • AntihypertensivesAntihypertensives: Based on a rabbit study, Aristolochia may decrease blood pressure (11).
  • Anti inflammatory agentsAnti inflammatory agents: Based on a mouse study and in vitro study, Aristolochia may have anti-inflammatory activity (52; 53).
  • Antineoplastic agentsAntineoplastic agents: Based on various laboratory tests, Aristolochia spp. may have cytotoxic activity (46; 50; 58; 4; 3; 1).
  • AntioxidantsAntioxidants: Based on an in vitro study, Aristolochia may have antioxidant activity (54).
  • AntiprotozoalsAntiprotozoals: Based on in vitro and animal study, Aristolochia may have antitrypanosome activity (61; 5).
  • Antispasmodic agentsAntispasmodic agents: Based on in vitro study using non-pregnant rat uteri, Aristolochia papillaris may have smooth muscle relaxant activity (57).
  • AntiveninsAntivenins: Based on mouse studies, Aristolochia may have antivenom activity, including the neutralization of the anticoagulant, hemolytic, and phospholipase activity of crude venom (62; 63; 64).
  • Cytochrome P450 metabolized agentsCytochrome P450 metabolized agents: The aristolochic acids present in Aristolochia spp. are reduced by the hepatic cytochrome P450 (CYP1A1/2), and its metabolism may affect the metabolism of other CYP450-metabolized agents (69; 70).
  • DexfenfluramineDexfenfluramine: Ingestion of dexfenfluramine may affect the development of urothelial carcinoma due to the aristolochic acid found in Aristolochia spp. (71).
  • FenfluramineFenfluramine: Ingestion of fenfluramine may affect the development of urothelial carcinoma due to the aristolochic acid found in Aristolochia spp. (71).
  • ImmunosuppressantsImmunosuppressants: Based on in vitro studies using RAW264.7 mouse macrophage cells, Aristolochia may have immunosuppressant activity (53; 59).
  • MethadoneMethadone: Based on an in vitro study, Aristolochia may reduce opiate withdrawal symptoms (65).
  • Muscarinic antagonistsMuscarinic antagonists: Based on animal studies, Aristolochia may have muscarinic activity (11).
  • Nephrotoxic agentsNephrotoxic agents: Due to its nephrotoxicity, the U.S. Food and Drug Administration (FDA) currently advises consumers to immediately discontinue use of any botanical products containing aristolochic acid. Currently, Britain's Committee on Safety of Medicines has prohibited Aristolochia spp. in all unlicensed medicines, and it may only be obtained by prescription from a licensed doctor or dentist. In case reports, use of Aristolochia spp. has dose-dependently lead to tubulointerstitial fibrosis, Fanconi syndrome, rapidly progressive nephropathy, chronic renal insufficiency, and urothelial cancer in humans due to its aristolochic acid content (12; 13; 73; 14; 15; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24; 25; 26; 27; 28; 29; 30; 31; 32; 33; 34; 35; 36; 37; 38; 39).
  • Neurotrophic drugsNeurotrophic drugs: Based on in vitro study, Aristolochia may promote both dendrite-like and axon-like process outgrowth (43).
  • OpiatesOpiates: Based on an in vitro study, Aristolochia may reduce opiate withdrawal symptoms (65).
  • OxytocicsOxytocics: Based on animal studies, Aristolochia may have oxytocic activity (11).
  • TobaccoTobacco: Smoking tobacco may affect the development of urothelial carcinoma due to the aristolochic acid found in Aristolochia spp. (71).

Aristolochia/Herb/Supplement Interactions:
  • AntibacterialsAntibacterials: Based on laboratory tests, Aristolochia spp. leaves, bark, and rhizomes may have antibacterial activity (46; 47; 6; 6; 44; 48; 7; 49).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Aristolochia spp. roots and stems may have antiplatelet properties (55; 56).
  • AntifungalsAntifungals: Based on laboratory studies, Aristolochia may have antimicrobial activity (50; 4; 4; 51).
  • AntihypertensivesAntihypertensives: Based on a rabbit study, Aristolochia may decrease blood pressure (11).
  • Anti inflammatory herbsAnti inflammatory herbs: Based on a mouse study and in vitro study, Aristolochia may have anti-inflammatory activity (52; 53).
  • AntineoplasticsAntineoplastics: Based on various laboratory tests, Aristolochia spp. may have cytotoxic activity (46; 50; 58; 4; 3; 1).
  • AntioxidantsAntioxidants: Based on an in vitro study, Aristolochia may have antioxidant activity (54).
  • AntiparasiticsAntiparasitics: Based on in vitro and animal study, Aristolochia may have antitrypanosome activity (61; 5).
  • AntispasmodicsAntispasmodics: Based on in vitro study using non-pregnant rat uteri, Aristolochia papillaris may have smooth muscle relaxant activity (57).
  • AntiveninsAntivenins: Based on mouse studies, Aristolochia may have antivenom activity, including the neutralization of the anticoagulant, hemolytic, and phospholipase activity of crude venom (62; 63; 64).
  • Cytochrome P450 metabolized herbs and supplementsCytochrome P450 metabolized herbs and supplements: The aristolochic acids present in Aristolochia spp. are reduced by the hepatic cytochrome P450 (CYP1A1/2), and its metabolism may affect the metabolism of other CYP450-metabolized agents (69; 70).
  • Ginkgo bilobaGinkgo biloba: Based on a rat study, Ginkgo biloba leaf may have protective effects on acute renal injury caused by Aristolochia spp. (75).
  • Herbs containing aristolochic acidHerbs containing aristolochic acid: Due to its nephrotoxicity, the U.S. Food and Drug Administration (FDA) currently advises consumers to immediately discontinue use of any botanical products containing aristolochic acid. Currently, Britain's Committee on Safety of Medicines has prohibited Aristolochia spp. in all unlicensed medicines, and it may only be obtained by prescription from a licensed doctor or dentist. In case reports, use of Aristolochia spp. has dose-dependently lead to tubulointerstitial fibrosis, Fanconi syndrome, rapidly progressive nephropathy, chronic renal insufficiency, and urothelial cancer in humans due to its aristolochic acid content (12; 13; 73; 14; 15; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24; 25; 26; 27; 28; 29; 30; 31; 32; 33; 34; 35; 36; 37; 38; 39).
  • ImmunosuppressantsImmunosuppressants: Based on in vitro studies using RAW264.7 mouse macrophage cells, Aristolochia may have immunosuppressant activity (53; 59).
  • Muscarinic antagonistsMuscarinic antagonists: Based on animal studies, Aristolochia may have muscarinic activity (11).
  • Nephrotoxic agentsNephrotoxic agents: Due to its nephrotoxicity, the U.S. Food and Drug Administration (FDA) currently advises consumers to immediately discontinue use of any botanical products containing aristolochic acid. Currently, Britain's Committee on Safety of Medicines has prohibited Aristolochia spp. in all unlicensed medicines, and it may only be obtained by prescription from a licensed doctor or dentist. In case reports, use of Aristolochia spp. has dose-dependently lead to tubulointerstitial fibrosis, Fanconi syndrome, rapidly progressive nephropathy, chronic renal insufficiency, and urothelial cancer in humans due to its aristolochic acid content (12; 13; 73; 14; 15; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24; 25; 26; 27; 28; 29; 30; 31; 32; 33; 34; 35; 36; 37; 38; 39).
  • Neurotrophic drugsNeurotrophic drugs: Based on in vitro study, Aristolochia may promote both dendrite-like and axon-like process outgrowth (43).
  • OpiatesOpiates: Based on an in vitro study, Aristolochia may reduce opiate withdrawal symptoms (65).
  • OxytocicsOxytocics: Based on animal studies, Aristolochia may have oxytocic activity (11).

Aristolochia/Food Interactions:
  • Insufficient available evidence.

Aristolochia/Lab Interactions:
  • ?2-Microglobulin?2-Microglobulin: Based on case studies, animal, and in vitro studies, aristolochic acid in Aristolochia may be nephrotoxic and may impair the uptake of ?2-microglobulin (12; 13; 73; 14; 15; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24; 25; 26; 27; 28; 29; 30; 31; 32; 33; 34; 35; 36; 37; 38; 39).
  • AlbuminAlbumin: Based on case studies, animal, and in vitro studies, aristolochic acid in Aristolochia may be nephrotoxic and may impair the uptake of albumin (12; 13; 73; 14; 15; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24; 25; 26; 27; 28; 29; 30; 31; 32; 33; 34; 35; 36; 37; 38; 39).
  • Blood smearBlood smear: Based on in vitro and animal study, Aristolochia may have antitrypanosome activity and may reduce the number of parasites in the peripheral circulation (61; 5).
  • Blood urea nitrogen (BUN)Blood urea nitrogen (BUN): Based on case studies, animal, and in vitro studies, aristolochic acid in Aristolochia may be nephrotoxic and may increase BUN levels (12; 13; 73; 14; 15; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24; 25; 26; 27; 28; 29; 30; 31; 32; 33; 34; 35; 36; 37; 38; 39).
  • Cerebrospinal fluidCerebrospinal fluid: Based on in vitro and animal study, Aristolochia may have antitrypanosome activity, but may not affect parasite numbers in the cerebrospinal fluid (61).
  • Coagulation panelCoagulation panel: Based on mouse studies, Aristolochia may have antivenom activity, including the neutralization of the anticoagulant activity of crude venom (62; 63; 64).
  • CreatinineCreatinine: Based on case studies, animal, and in vitro studies, aristolochic acid in Aristolochia may be nephrotoxic and may increase creatinine levels (12; 13; 73; 14; 15; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24; 25; 26; 27; 28; 29; 30; 31; 32; 33; 34; 35; 36; 37; 38; 39).
  • Estimated glomerular filtration rate (eGFR)Estimated glomerular filtration rate (eGFR): Based on case studies, animal, and in vitro studies, aristolochic acid in Aristolochia may be nephrotoxic and may lower eGFR (12; 13; 73; 14; 15; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24; 25; 26; 27; 28; 29; 30; 31; 32; 33; 34; 35; 36; 35; 38; 39).
  • HematocritHematocrit: Based on mouse studies, Aristolochia may have antivenom activity, including the neutralization of the hemolytic activity of crude venom (62; 63; 64).
  • Serum levels of Cytochrome P450 metabolized agentsSerum levels of Cytochrome P450 metabolized agents: The aristolochic acids present in Aristolochia spp. are reduced by the hepatic cytochrome P450 (CYP1A1/2), and its metabolism may affect the metabolism of other CYP450-metabolized agents (69; 70).
  • White blood cell (WBC) countWhite blood cell (WBC) count: Based on in vitro studies using RAW264.7 mouse macrophage cells, Aristolochia may have immunosuppressant activity (53; 59).

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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