Herbal medicinal products are becoming increasingly popular. At the same
time, the safety issues related to herbal drugs continue to be ignored
by the public, neglected by manufacturers and legislative bodies as well
as under-researched by the medical professions.
One safety aspect that is of growing importance is that of herb-drug
interactions, even though users of herbal medicines tend to believe that
they are naturally safe.
Experts are warning that even the commonly consumed bitter kola should
not be taken along side with many drugs, including malaria medicines and
common antibiotics.
Experts’ assessment of the risk associated with taking quinine sulphate
or other malaria medicines that contain quinine in them such as
Arthemisin Combination therapy (ACT) alongside bitter kola, found it
causes a reduction in the amount of the quinine that will be available
in the blood stream to kill malaria germs.
ACT is currently the drug recommended by the Federal Ministry of Health
for treating malaria, and some of them also contain quinine.
Bitter kola seed is chewed habitually for social reasons, for oral
hygiene and as a masticatory agent in Africa. It is believed to possess
many useful medicinal properties. It is usually used to treat throat
infections, cough and stomach upset as well as an anti-stress agent.
In most parts of Nigeria, patients on antibiotic therapy and malaria
medicines also chew bitter cola habitually or because of its
traditionally acclaimed anti-infective properties.
Drugs are essential components of medical therapy but concomitant
consumption of other substances with drugs can cause unintended and
unwanted outcomes which may lead to significant harm in some cases.
The risk of drug interactions increases with number of drugs being taken
by the patient. For example, the risk of interactions with six to 10
drugs may just be seven per cent but with 16 to 20 drugs, the risk may
increase up to 40 per cent.
High risk patients, such as elderly patients taking three or more
medications for chronic conditions are more susceptible to suffer from
such interactions. Many of such patients also use herbs, fruits,
vegetables and other nutrients due to their traditional and folk
benefits.
This trial to ascertain the effect of ingesting bitter kola on the
possible effective of quinine and other quinine containing malarial
medicines involved 24 healthy Nigerian volunteers.
These were experts at the Obafemi Awolowo University, Ile-Ife, Nigeria
in conjunction with their international collaborators. The 2015 study
was in the Journal of Clinical Pharmacology and included Igbinoba Sharon
, Onyeji CO, Akanmu MA, Soyinka JO, Pullela SS, Cook JM, and Nathaniel
TI.
Previously demonstrated was the negative effect of ingesting kolanut
alongside halofantrine, another antimalarial drug. Experts found that it
causes a significant decrease in its effectiveness in treating malaria.
According to the experts, report in the 2008 edition of the European
Journal of Clinical Pharmacology, caution should be exerted when the
drug is taken together with caffeine-containing nutrients.
Ingesting bitter kola alongside antibiotics such as ciprofloxacin
hydrochloride, abroad spectrum antibiotic to treat conditions such as
typhoid fever, experts have also cautioned on, saying it was better
avoided.
Studies in the laboratory showed the extract of bitter kola inhibit the
antimicrobial properties of several antibiotics including gentamycin,
tetracycline, co-trimoxazole, ciprofloxacin, ofloxacin,
amoxicillin-clavulanic acid (AugmentinR) and penicillin G.
Previously in 2007, studies in 10 healthy male volunteers, aged between
20 and 30 years suggested that bitter kola impairs the bioavailability
of ofloxacin by a binding itself to some chemical constituents of bitter
kola, thus reducing its antimicrobial effectiveness.
Ofloxacin is an antibiotic used to treat common ailments like
respiratory tract infections, upper and lower urinary tract infections
and skin infections.

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