Terminalia - Breztri (Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate) Interaction
Herbal: Terminalia
Also Known As: Terminalia arjuna, Abhaya, Amandier Indien, Arale, Arjuna, Axjun Argun, Badamier, Badamier chebule, Badamier Géant, Baheda, Bahera, Bahira, Bala Harade, Balera, Behada, Belleric Myrobalan, Belliric Myrobalan, Bhibitaki, Bibhitak, Bibitaki, Bihara, Black myrobalan
Drug: Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate
Brand names:
Breztri
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate is classified as belonging to the following category: Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2D6 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2D6 enzymes and reduces CYP2D6 substrate metabolism. However, animal research shows that taking Terminalia chebula for 15 days prior to administration of metoprolol, a CYP2D6 substrate, does not affect the metabolism of metoprolol.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16.
- Wu G, Dong Z, Dong J, et al. Effects of mongolian medicine Terminalia chebula Retz. on 6 CYP450 enzymes in rats. Int J Clin Exp Pathol 2020;13(12):3128-3138.
Interaction Details
Aerosphere Budesonide, Formoterol Fumarate, Glycopyrrolate is classified as belonging to the following category: Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that Terminalia arjuna extract inhibits CYP2C9 enzymes and reduces CYP2C9 substrate metabolism. However, animal research shows that taking Terminalia chebula for 15 days prior to administration of tolbutamide, a CYP2C9 substrate, does not affect the metabolism of tolbutamide.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16.
- Wu G, Dong Z, Dong J, et al. Effects of mongolian medicine Terminalia chebula Retz. on 6 CYP450 enzymes in rats. Int J Clin Exp Pathol 2020;13(12):3128-3138.
Terminalia Overview
Terminalia is a genus of trees that are native to tropical and subtropical regions of the world. There are around 100 species of Terminalia, which are known for their hard, durable wood and their ability to grow in a variety of climates.
In traditional medicine, three species are of particular note, Terminalia arjuna, Terminalia bellirica, and Terminalia chebula. Various parts of these trees, including the bark, leaves, and fruit, are used as a natural remedy for digestive problems, such as constipation and diarrhea, and to boost the immune system. They are also believed to have anti-inflammatory properties, and they may be helpful in reducing inflammation and swelling in the body.
Terminalia - More Interactions
Terminalia interacts with 884 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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