Berberine, cautions
Has drawbacks such as a lack of water solubility and absorption in the gut and toxicity at higher doses.
Cyclosporine (Neoral, Sandimmune) interacts with BERBERINE
The body breaks down cyclosporine (Neoral, Sandimmune) to get rid of it. Berberine might decrease how fast the body breaks down cyclosporine (Neoral, Sandimmune). This might cause there to be too much cyclosporine (Neoral, Sandimmune) in the body and potentially cause side effects.
Berberine is reported to up-regulate the expression of the human multidrug resistance gene coding for multidrug resistance transporter (pgp-170), thus the treatment of tumors with berberine may result in reduced retention of chemotherapeutic agents such as paclitaxel. In a randomized controlled clinical trial, 52 renal transplant recipients were treated with ciclosporin A and 0.2 g berberine three times daily for 3 months, while another 52 subjects received ciclosporin A alone . For a pharmacokinetic study, six renal transplant recipients were given a 3-mg/kg dosage of ciclosporin A twice daily before and after oral co-administration of 0.2 g berberine three times daily (i.e. berberine was given every 8 hours and cyclosporine every 12 hours) for 12 days. The results of this study showed that the trough blood concentrations and the ratios of concentration:dose of ciclosporin A in the berberine- treated group increased by 88.9% and 98.4%, respectively, compared with those at baseline (p < 0.05). Thus, berberine can markedly elevate the blood concentration of ciclosporin A in renal transplant recipients in both clinical and pharmacokinetic studies. This combination may allow a reduction of the dosage of ciclosporin A.(WHO-VOL4 pg 252)
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with BERBERINE
Some medications are changed and broken down by the liver.
Berberine might decrease how quickly the liver breaks down some medications. Taking berberine along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking berberine, talk to your healthcare provider if you are taking any medications that are changed by the liver.
Some medications changed by the liver include cyclosporin (Neoral, Sandimmune), lovastatin (Mevacor), clarithromycin (Biaxin), indinavir (Crixivan), sildenafil (Viagra), triazolam (Halcion), and many others.
Edwards DJ. Influence of goldenseal root on the pharmacokinetics of indinavir
Adulterants causing false negatives in illicit drug testing.
Berberinemay increase the antihypertensive action of antihypertensives; use cautiously.
Berberinemay increase the effect of calcium channel blockers