What medications interact with apigenin?

Drug Interactions with Apigenin

Direct Cytochrome P450 Interactions

Apigenin has minimal clinically significant drug interactions documented in the medical literature, but theoretical concerns exist based on its effects on cytochrome P450 enzymes.

CYP450 Enzyme Effects

• Apigenin acts as a substrate and potential modulator of CYP3A4 and other cytochrome P450 enzymes, though the clinical significance remains unclear 1
• Unlike well-characterized drug interactions with aprepitant (which is simultaneously a substrate, moderate inducer, and moderate inhibitor of CYP3A4), apigenin's interaction profile is not well-defined in clinical practice 2
• Further research about apigenin's ADME properties and drug-drug interactions are needed before it can be brought to clinical trials 1

Theoretical Interactions Based on Metabolism

Chemotherapy Agents

• Caution is warranted when combining apigenin with chemotherapeutic agents metabolized by CYP3A4, including docetaxel, paclitaxel, etoposide, irinotecan, ifosfamide, imatinib, vinorelbine, vinblastine, and vincristine 2
• Apigenin may interact beneficially with chemotherapeutic drugs and could potentially be used as an adjuvant agent, though this requires direct clinical studies 3
• When apigenin is used alongside cancer treatments, monitor for altered efficacy or toxicity of the chemotherapy agents 2

Anticoagulants

• While not specifically documented for apigenin, flavonoids can theoretically interact with warfarin through CYP450 enzyme modulation 2
• If combining apigenin with warfarin, monitor INR more frequently, particularly during the first 2-4 weeks of concurrent use 2
• Consider spacing administration if uncertain about interactions: take other medications at least 1 hour before or 4-6 hours after apigenin administration 4

Tyrosine Kinase Inhibitors

• Theoretical interactions may occur with TKIs that are CYP3A4 substrates, including gefitinib, imatinib, lapatinib, pazopanib, sorafenib, and sunitinib 2
• More intense patient monitoring is needed when drugs with potential CYP450 interactions are used together 2

Special Populations Requiring Caution

Patients with Liver Disease

• Use apigenin with caution in patients with liver disease, as metabolism may be affected 4
• Apigenin has demonstrated effects on liver function in preclinical studies, though it shows low intrinsic toxicity 1

Elderly Patients

• Monitor elderly patients closely due to increased susceptibility to drug interactions 4
• General caution is warranted with any medication combination in this population 5

Patients on Multiple Medications

• When apigenin is considered for therapeutic use, review the complete medication list to minimize potential interactions 4
• Pay particular attention to drugs metabolized exclusively by single CYP isoforms, as these are more vulnerable to interaction effects 2

Clinical Recommendations for Safe Use

• No specific dose adjustments or contraindications are established for apigenin in combination with other medications, as clinical interaction data is limited 1
• If therapeutic concentrations are desired (1-5 μmol/L), use semi-purified apigenin supplements in capsule form rather than dietary sources, which would require impractical amounts 3
• Monitor for individual side effects of each medication separately rather than anticipating combined adverse effects 6
• Consider apigenin's potential as an adjuvant to enhance chemotherapy efficacy or reduce side effects, though this requires further clinical validation 7, 8