For B.Pharm, 6th Semester

1. Study of following drugs and
their possible side effects and
interactions: kava-kava, Ginko
biloba, Ginseng, Garlic & Pepper.

2. kava-kava
• Biological source: Kava consists of dried roots
obtained from the plant- Piper methysticum. Family;
Piperaceae.
• kava-kava is a root found on South Pacific islands.
Islanders have used kava as medicine and in
ceremonies for centuries.
• “kava” contains substances called kavapyrones.
• Kava has a calming effect, wave changes similar to
changes that occur brain producing, for Valium
(diazepam with calming medicines such as example).
• Traditionally prepared as a tea, kava root is in powder
and tincture dietary supplement also available as
a(extract in alcohol) forms.

4. Uses
• Kava's calming effect may relieve anxiety,
restlessness, sleeplessness, and stress-related
symptoms such as muscle tension or spasm. Kava
may also relieve pain.
• When taken for anxiety or stress, kava does not
interfere with mental sharpness. When taken for sleep
problems, kava promotes deep sleep without affecting
restful REM sleep- Rapid eye movement sleep.
• Kava may be used instead of prescription anti-anxiety
drugs, such as benzodiazepines and tricyclic
antidepressants.

5. Precaution
• Kava should never be taken with anti-anxiety
drugs, such as benzodiazepines and tricyclic
anti-depressants prescription drugs.
• Avoid using alcohol when taking kava.

6. Side effects
• Kava may have severe side effects and should not be used by
everyone.
• Kava has caused liver failure in previously healthy people.
• You should not use kava for longer than 3 months without
consulting your doctor.
• Long-term kava use may result in:
-Liver problem
-Shortness of breath (reversible).
-Scaly rash (reversible).
-Facial puffiness or swelling (reversible).
• Before you use kava, consider that it:
-Avoid alcohol or psychotropic medicines.

7. GINKO BILOBA
• Biological Source:
Ginkgo consists of dried leaves
obtained from the dioeceous
tree Ginkgo biloba, belonging to
family Ginkgoaceae.
• Ginkgo is a large tree with fan-
shaped leaves. Although Ginkgo
is native parts of Asia, including
China, Japan, and Korea.
• It is one of the longest living tree
species in the world.
• Ginkgo trees can live as long as a
thousand years. Using ginkgo for
was described in 2600 BC.

8. USES
• Ginkgo leaf is often taken by mouth for memory
disorders. It is also used for conditions Alzheimer
• It is also used for conditions that seem to be due to
reduced blood flow in the brain especially in older
people.
• These conditions include, memory loss, headache,
difficulty concentrating, mood disturbances, and
hearing disorders.
• Ginkgo leaf is also used for thinking disorders related
to Lyme disease, chemotherapy and depressant.
• Some people use ginkgo to treat sexual performance
problems.
• Used in eye problem, including glaucoma.

9. Side effects
• It can cause some minor side effects such as stomach upset,
headache, dizziness, constipation, forceful heartbeat, and
allergic skin reactions.
• There is some concern that ginkgo leaf extract might
increase the risk of liver and thyroid cancers. But, this has
only occurred in animals given extremely high doses of
ginkgo. There is not enough information to know if it could
happen in humans.
• Ginkgo fruit and pulp can cause severe allergic skin
reactions and irritation of mucous membranes.
• Eating more than 10 roasted seeds per day can cause
difficulty breathing, weak pulse, seizures, loss of
consciousness, and shock.

10. Interaction
• May ↑ bleeding with anticoagulants
• May ↑ activity and side effects of MAO
inhibitors
• Increases blood pressure when combined with
a thiazide diuretic and even caused coma
• Increases the digoxin plasma levels.
• Ginkgo can slow blood clotting. Ibuprofen
can also slow blood clotting.

11. Some marketed products

12. GINSENG
• Biological source: it
consists of the dried root
of plants in the genus
Panax, such as
Korean ginseng (P. ginseng)
Family: Araliaceae.
• Is an herb
• Declared a threatened or
endangered species in
some states in the United
States.

13. Uses
• Stress management, to boost the immune system, and as a
stimulant .
• Fight infections such as colds and flu.
• Used as an adaptogen (adapt to internal/external stressors,
fight fatigue, increase stamina), for anxiety, athletic/physical
stamina enhancement, cognitive function, enhancement,
depression, fertility (male), headaches, immuno-stimulant,
menopausal hot flashes, and impotence.
• To improve digestion and for loss of appetite, as well as for
vomiting, inflammation of colon.
• Improving athletic performance, improving mental
performance, as an anti-aging aid, menopausal symptoms,
complications during pregnancy and childbirth.

14. Side effects
• Panax ginseng is POSSIBLY UNSAFE when
taken for more than 6 months. Researchers think
it may have some hormone-like effects that could
be harmful with long-term use.
• The most common side effect is trouble sleeping
(insomnia). Less commonly, people experience
menstrual problems, breast pain, increased heart
rate, high or low blood pressure, headache, loss of
appetite, diarrhea, itching, rash, dizziness, mood
changes, vaginal bleeding, and other side effects.
• When applied to the skin, It might cause side
effects such as irritation and burning.

15. Interaction
• Increases the AUC of digoxin
• Decreased activity of opioids–clear mechanism is unknown
• Increased CNS side effects due to additive effect of
-MAO inhibitors
-Phenelzine
• Warfarin (Coumadin) interacts with AMERICAN GINSENG-
might increase the risk of clotting.
•
• Medications for diabetes (Antidiabetes drugs) interacts
with AMERICAN GINSENG

16. Garlic
• Garlic is the ripe
bulb of Allium
sativum Linn.,
belonging to family
Liliaceae.
• Garlic Contains a
Compound Called
Allicin, Which Has
Potent Medicinal
Properties

17. uses
• Garlic supplementation is known to boost the
function of the immune system.
• One large 12-week study found that a daily garlic
supplement reduced the number of colds by 63%
compared with placebo.
• Human studies have found garlic supplementation to
have a significant impact on reducing blood pressure
in people with high blood pressure.
• For those with high cholesterol, garlic
supplementation appears to reduce total and/or LDL
cholesterol by about 10-15%.

18. Side effects
• When taken by mouth, garlic can cause bad
breath, a burning sensation in the mouth or
stomach, heartburn, gas, nausea, vomiting,
body odor, and diarrhea.
• when applied to the skin, garlic might cause
skin damage that is similar to a burn.
• RAW garlic is POSSIBLY UNSAFE when applied
to the skin. Raw garlic might cause severe skin
irritation when it is applied to the skin.

19. Interaction
– May ↑ bleeding times with anticoagulants
– ↓ blood levels and toxicity of protease
inhibitors like ritonavir, indinavir.

20. Black pepper
• BIOLOGICAL SOURCES: Piper
nigrum, also known as black
pepper is the member
of Piperaceae family.
• Because of its antibacterial
properties, pepper is also
used to preserve food.
• It is a rich source of
manganese, iron, potassium,
vitamin-C, vitamin K, and
dietary fiber. Black pepper is
also a very good anti-
inflammatory agent

21. USES
• The health benefits of black pepper include relief from
• Respiratory Disorders,
• Coughs,
• The Common Cold,
• Constipation,
• Indigestion,
• Anemia,
• Impotency,
• Muscular Strains,
• Dental Disease,
• Pyorrhea,
• Diarrhea, And
• Heart Disease.

22. Side effects
• Taking large amounts of black pepper by
mouth, which can accidentally get into the
lungs, has been reported to cause death.
• If it gets into the eyes, black pepper can burn.
Some people might develop an allergy to black
pepper.
• Inhaling black pepper oil through the nose or
mouth can cause cough. Some people might
develop an allergy to black pepper.

23. Interaction
• Black pepper might decrease how quickly the liver breaks
down some medications
• lovastatin (Mevacor)
• ketoconazole (Nizoral)
• Itraconazole (Sporanox).
• It will decrease the action of antacids
• The black pepper majorly shows interaction and increase the
AUC of The drugs are: