Evaluation of herb-drug interaction of Withania somnifera with anti-rheumatic drugs through high-throughput screening

Abstract

Rheumatoid Arthritis is an autoimmune inflammatory joint disease. Disease-modifying anti-rheumatic drugs and Non-steroidal anti-inflammatory drugs are being used for its management and found to have better improvement when combined with a traditional medicine. Withania somnifera (Ashwagandha) is one among the medicinally important herb which is known to be beneficial in these conditions. The root of the plant is safely being used however, very less is known about the aerial part usage; and their interactions with anti-rheumatic drugs. Cytochrome P450 enzymes inhibition assay for subtypes CYP3A4 and CYP2D6 isozyme was used in concoction of hydroalcoholic and methanolic extracts of root and aerial part of the plant with the anti-arthritic drugs. All the four Withania somnifera extracts showed significantly higher (P100μg/mL) compared to positive control ketoconazole and Quinidine respectively. Combination of formulation and anti-rheumatic drugs showed significantly (P