Herb–Drug Interactions in Traditional Cardiovascular Therapy: Pharmacokinetic Mechanisms and Safety Integration in Folk Medicine
Keywords:
herb-drug interactions; cytochrome P450; traditional medicine; cardiovascular pharmacology; pharmacokinetics; folk medicine; Uzbekistan; patient safetyAbstract
Herbal cardiotonics occupy a prominent place in Central Asian traditional medicine, and their concurrent use with conventional cardiovascular pharmacotherapy is common among patients with heart failure and related conditions in Uzbekistan. This narrative review synthesizes current evidence on herb–drug interactions relevant to traditional cardiovascular remedies, with emphasis on pharmacokinetic mechanisms, cytochrome P450-mediated metabolism, and clinical safety considerations. Herbal constituents commonly used in Uzbek folk cardiotonic preparations can modulate hepatic enzyme activity, alter the bioavailability of anticoagulants, antiarrhythmics, and cardiac glycosides, and interact through both pharmacokinetic and pharmacodynamic pathways. Reported interactions range from clinically silent enzyme induction to potentiation of bleeding risk and altered drug clearance. Systematic clinical evaluation of these interactions remains limited despite widespread concurrent use. Structured safety monitoring, clinician awareness, and pharmacovigilance frameworks are needed to support the responsible integration of traditional cardiovascular remedies with modern pharmacotherapy in regional healthcare settings.
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