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Efficacy and safety of curcumin in combination with paclitaxel in patients with advanced, metastatic breast cancer


Daniel
(@daniel)
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Overall, treatment with curcumin in combination with paclitaxel was superior to the paclitaxel-placebo combination with respect to ORR and physical performance after 12 weeks of treatment. Intravenously administered curcumin caused no major safety issues and no reduction in quality of life, and it may be beneficial in reducing fatigue. https://www.sciencedirect.com/science/article/pii/S0944711320300507


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dng050
(@dng050)
Joined: 2 years ago
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Will curcumin IV (or any other phytochemical given IV) avoid the potential drug interactions which we might get when taking curcumin orally?  


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Daniel
(@daniel)
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Which interactions are you referring to @dng050 ? Are you referring to the interaction of piperine with some drugs that need to be metabolized in order to be effective? When that is an issue, I would use Curcumin without Piperine, or I would take Curc with Piperine several hours away from the specific drug, to give that drug time to be absorbed. However, the intravenous route is clearly the best way to deliver Curcumin into the blood stream.

Kind regards,
Daniel


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dng050
(@dng050)
Joined: 2 years ago
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@daniel, I was thinking about these studies which suggest that curcumin is either an inducer/inhibitor/activator of CYP3A4, which many drugs are metabolized by:

* Effects of Curcumin on the Pharmacokinetics of Loratadine in Rats: Possible Role of CYP3A4 and P-glycoprotein Inhibition by Curcumin (link) 

* Oral intake of curcumin markedly activated CYP 3A4: in vivo and ex-vivo studies (link)

* Practical Application of “ABOUT HERBS” website: Herbs and Dietary Supplement Use in Oncology Settings (link

"Curcumin has known HDIs with human liver cytochrome P450 enzymes 40-43and may interfere with chemotherapy drugs such as doxorubicin and cyclophosphamide.44 It may also interact with drug classes like tyrosine kinase inhibitors, which strongly inhibit CYP3A4.45 The potential for HDIs specifically with CYP2C9, according to a pre-clinical study showed an inhibitory concentration (IC50) of 4.3 μM,46 which can be an achievable curcumin serum level. However, a small-scale clinical study did not show a significant decrease in metabolite levels of the CYP3A4 probe drug midazolam, even with piperine-prepared curcuminoids at a 4 g one-time dose.47"

***

We are very much impressed by curcumin, but have not dared to try it since we have not seen studies wich clearly rules out potential interactions with drugs metabolized by CYP3A4. 

 


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johan
(@j)
Joined: 3 years ago
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Posted by: @dng050

Will curcumin IV (or any other phytochemical given IV) avoid the potential drug interactions which we might get when taking curcumin orally?  

Drug Development and Drug Interactions | Table of Substrates, Inhibitors and Inducers

https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and-drug-interactions-table-substrates-inhibitors-and-inducers

Curcumin isn't listed as CYP3A4 inhibitor/inducer. (maybe it's not up to date, don't know)

The IV route makes sense to me if you'd wanted to reduce potential drug interactions.


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