Natural Medicines Newsletter

Volume 2, Issue 4, 01/26/2010

Question

Which Chinese and Indian herbs or natural medicines are known to inhibit xanthine oxidase and are potentially useful for treating hyperuricemia or gout?

Answer

As noted in the previous issues with herbs from North and South America, gout has not only been a medical problem for centuries, but is also increasing in prevalence across the world.(1-3)  Despite the availability of allopurinol (Zyloprim®, Aloprim®) and febuxostat (Uloric®) as xanthine oxidase (XO) inhibitors for the treatment of gout, many patients may use supplements with claims for the treatment of gout without the knowledge of the clinician.(4,5)  This is especially true given the rise in the use of herbal and natural medicines and as such clinicians need to be able to recognize which products confer the same biological effect as other standard medications on the market.  This is not only important so that proper education and counseling can be provided to patients, but to also avoid duplicating treatment with agents that exert similar biologic effects and/or that could cause life-threatening drug interactions (such as those that can occur when azathioprine mediated metabolism through XO is inhibited thereby putting the patient at significant risk for bone marrow suppression).  Therefore, in continuation of this series of issues related to herbs that are inhibitors of XO, the next two natural medicines related issues will be dedicated to herbs from various parts of Asia that are known to inhibit XO.

The herbs or natural medicines mainly from China and India which are of potential clinical relevance are summarized in the table below.(7,8)   It is important to note that the type of herbal...

The full answer to this issue contains a table summarizing all of the Chinese and Indian herbs and their pharmacokinetic characteristics in the inhibition of xanthine oxidase

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