Types of herbal product* Herbal products Study type Subject/model (number) Study design Outcome measures Effect Mechanism References TCM Acorus calamus Linn.Animal Male Wistar rats with pentylenetetrazole-induced seizure model Randomized controlled study PK and PD parameters No effect on plasma level of CBZ Increased GABAergic activity Katyal et al. 2012 [35 ] TCM Berberine (active compound in Coptidis rhizome) Animal Male Wistar rats (5 in each group) Randomized parallel design PK parameters No effect on pharmacokinetic parameters of CBZ or CBZ 10,11-epoxide Did not affect in vivo intestinal or hepatic CYP3A activity Qiu et al. 2009 [36 ] TCM Cardiospermum halicacabum Linn.Animal Male Wistar rats (10 in each group) Randomized crossover design PK and PD parameters No significant effect on CBZ plasma level N.D. Thabrew et al. 2004 [37 ] TCM Cassia auriculata Linn.Animal Male Wistar rats (10 in each group) Randomized crossover design PK and PD parameters Increased plasma level of CBZ N.D. Thabrew et al. 2004 [37 ] TCM Chai-hu-jia-long-gu-mu-li- tang Animal Wistar rats Randomized parallel design PK parameters No effect on pharmacokinetic parameters or protein binding of CBZ or CBZ 10,11-epoxide Did not alter in vivo CYP3A activity Ohnishi et al. 2001 [38 ] TCM Ginsenoside ginseng ) In vitro Human liver microsomes N/A PK parameters Increased CBZ metabolism Activated CYP3A4 activity by interacting with CBZ in the active site Haop et al. 2008 [39 ] TCM Ginkgo biloba Animal Rats Randomized parallel design PK parameters Decreased bioavailability and increased rate of elimination of CBZ N.D.
Chandra et al. 2009 [40 ] TCM Hu-gan-ning pian Animal Male Sprague-Dawley rats Randomized parallel design PK parameters Decreased bioavailability
,
,
, CL, and elimination K of CBZ Decreased absorption but not metabolism of CBZ Zheng et al. 2009 [41 ] TCM Hypericum perforatum Linn.Human Healthy subjects Open label study PK parameters No effect on PK parameters of CBZ Autoinduction or greater clearance by CBZ Burstein et al. 2000 [42 ] HP Ispaghula Husk Human Healthy male volunteer (4) Open label study PK parameters Decreased bioavailability by reducing absorption and plasma levels of CBZ Decreased amount of biological fluid in GI tract and thereby reduced dissolution rate of CBZ Also adsorb CBZ onto their surfaces
Etman 1995 [43 ] TCM Jia-wei-xiao-yao-san Human Patients with major depression or bipolar disorder (61) Randomized double-blinded control trial PK parameters Decreased plasma level of CBZ Increased metabolism of CBZ by inducing CYP3A Zhang et al. 2007 [44 ] HP Mentat Animal New Zealand white rabbits Randomized parallel design PK parameters Increased bioavailability of CBZ N.D. Tripathi et al. 2000 [45 ] TCM Paeoniae Radix Animal Male Sprague-Dawley rats Randomized parallel design PK parameters Decreased
of CBZ
,
, CL, and F of CBZ Improved dissolution of CBZ Chen et al. 2002 [46 ] TCM Piperine Piper longum Human Patients with epilepsy Open label, crossover study PK parameters Increased bioavailability of CBZ
Decreased metabolism/ elimination and/or increased absorption of CBZ Pattanaik et al. 2009 [47 ] TCM Platycodonis Radix Animal Rabbits Randomized parallel design PK parameters Increased plasma level of CBZ Improve CBZ absorption by increasing its solubility and stimulating bile secretion Liu and Wei 2008 [48 ] TCM Polygonum cuspidatum Animal Male Sprague-Dawley rats Randomized crossover design PK parameters Increased level of CBZ and CBZ 10,11-epoxide in plasma, brain, liver, and kidney Inhibited CYP3A in intestine and MRP2 in the kidney Chi et al. 2012 [49 ] HP Septilin Animal Male rabbits Randomized crossover study PK parameters Decreased absorption of CBZ Affected gastric emptying time or intestinal transit time Garg et al. 1998 [50 ] TCM Xiao-cha-hu-tang Animal Female Sprague-Dawley rats Randomized parallel design PK parameters Increased
, decreased
of CBZ and AUC of CBZ 10,11-epoxide
, and MR
of CBZ Decreased GI absorption of CBZ by decreasing gastric emptying rate Ohnishi et al. 2002 [51 ] TCM Xiao-qing-long-tang Animal Male Wistar rats (4–6 in each group) Randomized parallel design PK parameters Increased
, elimination K of CBZ and decreased
MR
of CBZ
and AUC of CBZ and CBZ 10,11-epoxide Decreased gastric emptying rate and accelerated metabolism of CBZ Ohnishi et al. 1999 [52 ] TCM Xiao-yao-san Human Patients with major depression or bipolar disorder Randomized double-blinded control trial PK and PD parameters Decreased plasma level of CBZ and increased incidence of dizziness, blurred vision, skin rash, and nausea N.D. Li et al. 2005 [53 ]
