BENEFICIAL ROLE OF HERBAL HEPATOPROTECTANTS: A NOVEL APPROACH TO PREVENT HEPATOTOXICITY DUE TO ANTITUBERCULOSIS TREATMENT

Abstract

The first line antituberculosis drugs, isoniazid, rifampicin and pyrazinamide continue to be the effective in the treatment of tuberculosis; however, their use is associated with toxic reactions in tissues, particularly in the liver, leading to hepatitis. Hepatotoxicity has been reported in Indian patients at a high risk (up to 11.5%) than in their western counterpart (up to 4.3%). Since all the drugs used in the treatment of tuberculosis are shown to have hepatotoxic effects, studies have been performed to prevent or reduce the toxicity by the use of natural herbal drugs without interfering with the therapeutic actions of the drugs. Management of liver disease is still a challenge to the modern medicine. In the absence of reliable liver-protective drugs in the allopathic medical practices, herbs play a vital role in the management of liver disorders. In traditional medicine, the plants have been used to cure jaundice. In Indian ayurvedic medicine, the oral administration of extracts of dried rhizomes and roots are claimed as a cure for human viral hepatitis. The present review summarizes the list of plants/herbal formulations studied for their hepatoprotective activity in antitubercular drugs-induced hepatitis. However, despite extensive positive research data from experimental studies for herbal drugs in antitubercular drugs-induced hepatitis, and a clinical study, large scale clinical trials are needed to explore the hepotoprotective potential of herbal medicines in antitubercular drugs-induced hepatotoxicity.

KEY WORDS: Tuberculosis, herbal drugs, hepatotoxicity, antitubercular drugs