HDT Unit 2: Nutraceuticals Global Market Overview And Growth Of Nutraceutical Segment

Nutraceuticals
Mr. Omkar B. Tipugade
M-Pharm (Pharmaceutics)
Assistant Professor
Genesis Institute of Pharmacy, Radhanagari

Nutraceuticals
- The term nutraceutical was coined from Nutrition and Pharmaceutical in 1989 by Dr. Stephen De
Felice, USA.
- The term “Nutraceutical” combines the two words of “Nutrient,” which is a Nourishing Food
Component, and “Pharmaceutical,” which is a Medical Drug.
- Nutraceutical can be defined as a food or a part of food or a nutrient, which in addition to its
nutrient values provides health benefits including promotion of health and prevention of disease.
- These foods provides health benefits to reduce the risk of chronic diseases and basic nutrition.
- A nutraceutical may be a Naturally Nutrient- Rich Food such as spirulina, garlic, soy or a specific
component of a food like omega-3 oil from salmon.

Nutraceuticals
- They are also known as medical foods, nutritional supplements and dietary supplements.
- Foods and nutrients play a vital role in the normal functioning of the body. They help to maintain the
health of the individual and to reduce the risk of various diseases.
- Examples of nutraceuticals are natural foods, antioxidants, dietary supplements, daisy products,
citrus fruits, vitamins, minerals, milk and cereals. These products are generally consumed without medical
prescription and supervision.

GLOBAL MARKET OVERVIEW AND GROWTH OF
NUTRACEUTICAL SEGMENT
- The production or growth of nutraceuticals market in USD 671.30 billion by 2024.
- Developing countries have a high prevalence of non-communicable diseases like cancer, diabetes,
cardiovascular ailments, etc, therefore the demand for nutraceuticals is expected to rise in these nations.
- Nutraceuticals are also gaining global importance and have become a part of daily diet due to
increased risk of diseases due to improper life style and people consciously adapting preventive
healthcare measures.
- The gradually increasing healthcare expenses are also stimulating the demand for nutraceuticals.
- Most of the countries used nutraceuticals in disease like diabetes, heart problem

- The nutraceutical industry lies under three main segments which include functional foods, dietary
supplements, and herbal/natural products. The nutraceutical product are produced under good
manufacturing practices (GMP). In 2007, nutraceuticals sale is projected to reach $74.7 billion at an
AAGR of 9.9%.
- Nearly 6.1 Billion people trust on the healing power of plant based material for many reason like
safety, availability, less side effect and believe in traditional cure.
- According to a recent report, the total market for nutraceuticals in India is growing at 21 % per
annum. It has been growing much faster than global rates at CAGR of 18% for the last 3 years driven by
functional food and beverages categories.

- The most rapidly growing segments of the industry were dietary supplements (19.5 % per
year) and natural/herbal products (11.6 % per year).
- Internationally nutraceutical are gaining importance and are becoming a part of the consumers daily
diet. The major reasons for this change are the increasing occurrence of lifestyle disease and people
intentionally taking preventive healthcare measures.

SCOPE OF NUTRACEUTICALS
Nutraceuticals are expected to deliver promising outcomes in the prevention and occurrence of
various diseases resulting due to improper lifestyle and food habits. Various constituent of plants like
catechins, carotenoids, lycopene, polyphenols, PUFA, etc have been very effective in the prevention and
occurrence of various diseases like cardiovascular, arthritis cancer, gastrointestinal disorders, etc.

TYPES OF NUTRACEUTICAL PRODUCTS AVAILABLE
IN THE MARKET
Various nutraceuticals products available in the market are divided into following types:
1. Functional Foods:
- Functional food are intended to allow customers to eat enriched foods which are natural in nature
and not to take dietary supplements manufactured in liquids or capsule form.
- Food product to be taken as part of the usual diet to have helpful effect that go beyond based
nutritional function. Functional food contain physiological active components obtained either from plant or
animal sources.
- Sometimes, additional complementary nutrients are also added. E.g. Vit D is added to milk.

IN THE MARKET
- In general functional foods are the ordinary food that has components added to give it a specific
medical or physiological benefit along with nutritional effect.
- e.g. Cereals, Dairy, Functional Fats, Baby Food.

IN THE MARKET
Chemical Constituents Source Uses
Lycopen Guava, Papaya, Watermelon,
Tomatoes
Reduce cholesterol levels,
Antioxidants, Protect against cancer
ß-Carotene Vegetables, Fruits, Oats,
Carrotes
Antioxidant
Tocotrienol Palm oil Improve cardiovascular health, fight
against cancer
Curcumin Turmeric root Strongly anti-inflammatory and
Strong anti-oxidant

IN THE MARKET
2. Dietary Supplements:
- A Dietary supplements is a product that contain nutrients derived from food products that are
concentrated in liquid or capsule form.
- It is a product taken by mouth and contain a dietary ingredient proposed to supplement the diet.

IN THE MARKET
- Dietary supplement can be extracts or concentrates and may be found in many forms like tablet,
capsule, softgel, liquids or powders. These product include vitamins, minerals, herbs, amino acid etc.
- Dietary supplements do not have to be approved by the U.S. Food and Drug Administration (FDA)
before marketing but include a label that says “ These statements have not been evaluated by the FDA.

HEALTH BENEFITS OF NUTRACEUTICALS
- it may increase the health value of our diet
- it may help us live-life longer
- it may help to avoid a particular medical condition
- it may present food for populations with special needs.

ROLE OF NUTRACEUTICALS IN VARIOUS DISEASES
- Nutraceuticals play an important role in therapeutic areas such as arthritis, cancer, diabetes
digestion, cholesterol, blood pressure, pain killers, depression and various other disorder.
Cardiovascular diseases:
- Worldwide, the burdens of chronic diseases like cardiovascular diseases, cancers, diabetes and
obesity is rapidly increasing.
- Cardiovascular diseases (CVD) is the name for the group of disorders of the heart and blood vessels
and include hypertension (high blood pressure), coronary heart disease (heart attack), cerebrovascular
disease (stroke), heart failure, peripheral vascular disease, etc.

- Majority of the CVD are preventable and controllable. It was reported that low intake of fruits and
vegetables is associated with a high mortality in cardiovascular disease.
- Dietary fibers, antibiotics omega-3-polyunsaturated fatty acids, vitamins, minerals are for the
prevention under treatment of CVS disease.
- Polyphenol (in grape) prevent and control arterial diseases Flavonoids (in onion, vegetables, grapes,
red wine, apples, and cherries) block the ACE and strengthen the tiny capillaries that carry oxygen and
essential nutrients to all cells. Rice bran lowers the serum cholesterol levels in the blood, lowers the level of
(LDL) and increases the level (HDL) in cardiovascular health.

- Rice bran contains both Lutein and Zeaxanthin, which improves eyesight and reduces the chance of
cataracts. The essential fatty acids, omega-3, omega-6, omega-9, and folic acid in rice bran are also
promoting eye health.
- Various nutraceuticals are used to treat CVS disease are Phytosterols, Polyphenols, Flavonoids,
Vitamin E, Curcumin, Omega-3-fatty acids, Garlic

Diabetes
- Diabetes mellitus is characterized by abnormally high levels of blood glucose, either due to
insufficient insulin production, or due to its ineffectiveness.
- The use of ethyl esters of N-3 Fatty Acids may be beneficial in diabetic patients. Docosahexaenoic
acids (DHA) modulate insulin resistance and are also vital for neurovascular development.
- DHA plays a key role in the development of eye and nerve tissues. Various nutraceuticals are used to
treat diabetes are Antioxidant, Vitamin C, Calcium, vitamin D, Carbohydrates, Fat, Protein.

Cancer
- Flavonoids which block the enzymes that produce estrogen reduce of estrogen induced cancers.
- Phytoestrogens is recommended to prevent prostate/breast cancer.
- Soy foods are source of Iso-flavones, curcumin from curry and soya isoflavones possess cancer chemo
preventive properties.
- Lycopene concentrates in the skin, testes, adrenal and prostate protects against cancer. Saponins
contains antitumor and antimutagenic activities.
- Curcumin (diferuloylmethane) which is a polyphenol of turmeric possesses anti-carcinogenic,
antioxidative and anti-inflammatory properties.

- - Beet roots, cucumber fruits, spinach leaves, and turmeric rhizomes were reported to possess
anti-tumor activity.

Irritable Bowel Syndrome
- Inflammatory bowel diseases/ syndrome including Crohn’s disease and ulcerative colitis are a group
of idiopathic chronic and relapsing inflammatory disorders of the GIT tract/.
- Nutraceuticals is a broad term used to describe any product derived from food sources claiming extra
health benefits beyond the intrinsic nutritional value found in foods. The beneficial effects of nutraceutical
compounds in human health have been emerging in the last decades.
- Various nutraceuticals are used to treat IBD syndrome are Curcumin, Aloe vera, Garlic, Honey,
Probiotics, Minerals.

Gastro-intestinal Disease
- Eating habits and trends in food production and consumption have health, environmental and social
impacts. Diet has implications on gut health. Gut complications, such as ulcerative colitis, Crohn's disease,
irritable bowel syndrome, and gluten therapy-resistant celiac, result from overgrowth and imbalance of
intestinal microbial flora and are related to one’s diet.
- Various nutraceuticals are used to treat GIT disease are: Curcumin, Aloe vera, Garlic, Honey,
Probiotics, Minerals, Carbohydrates, Omega -3- fatty acid.

HERBS AS HEALTH FOOD
Alfaalfa
Biological Source: It is the entire plant of Medicago sativa.
Family: Fabacene
Chemical Constitute:
- Leaves, sprouts and seed contain vitamin-K, vitamin-C, copper,
manganese, folate, thiamine riboflavin, magnesium and iron. One cup of
sprouts contains one gram of protein and one gram of carbohydrates. It
also has a high content of bioactive compounds like saponins
coumarins, flavonoids, phytosterols, phytoestrogens and alkaloids.

Alfaalfa
- Alfalfa leave contain triterpenoids sapanins. The leaves are safer to use than the seeds contain the
toxic amino acid L-canavanine.
Uses:
- Used as Hypo cholestremic. - Anti hypertensive
- Diuretic - Anti arthritic.
- To treat kidney stones - Anti diabetic.
- To relieve menopausal symptoms - Antioxidant
- Works as a cleanser - Maintain healthy skin

Chicory
Biological Source: : It is obtained from the plant Cichorium intybus.
Family : Asteraceae.
- Chicory contains a variety of nutrients which include
carbohydrates, protein, vitamins, minerals, soluble fiber, phenolics,
Inulin, coumarin, tannins, monomeric flavonoids, sesquiterpene
lactones and beta carotene

Chicory
Uses:
- Helps in digestion - Improves heart health
- As Anti-cancer - Reduce arthritis pain
- Reduce weight - Treat constipation
- Improve immunity - Relieves anxiety
- Treat kidney disorder.

Ginger
Biological source: It is the dried rhizomes of Zingiber officinale.
Family: Zingiberace
- It contains volatile oils, minerals, resins. Ginger oil contains
zingiberine, bisaboline, farnesene, sesquiphellandrene and curcumene.
- Resins contain phenolic ketones such as gingerols, shogaols,
zingerone and other compounds.

Ginger
Uses:
- Reduce muscle pain and soreness. - Lower blood sugar
- Improve heart health - Treat chronic indigestion
- Lower cholesterol level - Prevent cancer
- Improve brain function - Protect against Alzheimer disease
- Help fight against infection - Help to treat nausea and vomiting
- Menstrual Cramp

Fenugreek
Biological source: It consists of seeds of the plant Trigonella foenum-graecum.
Family: Leguminosae.
Chemical constitute:
- It contains alkaloids (Gentiamine, Trigonelline), flavonoids,
coumarins, proteins, amino acids and steroidal saponins.
- Leave also cobtain about 86.1 % moisture, 4.4% protein, 0.9% fat,
1.5% minerals, 1.1% fiber and 6% carbphydrate.
- The mineral and vitamin present in leave are calcium, zinc, iron, phosphorous, riboflavin, thiamine, niacin
and vitamin C.

Fenugreek
Uses:
- To enhance milk production in new mothers. - Reduce appetite
- To maintain blood sugar level. - Reduce fat mass
- To boost libido - Maintain liver & kidney health
- To ease skin inflammation or injury. - Soothe muscle pain
- Balance cholesterol - Reduce menstrual cramps

Garlic
Biological Source: It consists of dried bulbs of Allium sativum.
Family: Liliaceae.
Chemical constituents:
- Garlic contains, carbohydrates, proteins, fats, mucilage, volatile oils and minerals.
- The volatile oil contain allin, allicin, allyl propyl disulfide, diallyl disulfide.
- Minerals contain phosphorous, iron and copper.

Garlic
Uses:
- Anti-cancer effect - Anti-diabetic agent
- Hepatotoxicity - Anti-microbial effect
- Anti-protozoal properties - Anti-fungal properties

Honey
Biological Source: Honey is a sugar like secretion deposited in
honeycomb by the bees Apis mellifera, A. dorsata & other species of Apis.
Family: Apidae.
Chemical constituents:
- Honey is an aqueous solution containing 35% glucose, 45% fructose and 2% sucrose.
- Honey include main compound like protein, vitamin, amino acid, minerals and organic acids.
- Pure honey also consist of flavonoids, polyphenols, reducing compound, alkaloids, glycoside, cardiac
glycoside, anthraquinone and volatile compound.

Honey
- Honey also consist of some important amino acid such as all nine essential amino acids and all non-
essential amino acid except for asparagine and glutamine.
- Flavonoids and polyphenols present in it produce anti-oxidant activity.
Uses:
- Wound healing activity - Treat diabetes
- Anti-cancer effect - Treat asthma
- treat CVS - Treat GI disease

Amla
Biological Source: It consists of fruits of the plant Emblica officinalis and Phyllanthus emblica.
Family: Euphorbiaceae
Chemical constituents: It contains Vitamin-C (ascorbic acid), calcium, iron and phosphorous.
Uses:
- It is used as Diureti
- Laxative
- Used in the treatment of Anaemia, Diarrhoea, Jaundice
- Fruits are used to prepare shampoos and hair oils

Ginseng (शतावरी)
Biological Source: It consists of roots of the plant Panax ginseng and other species of Panar.
Family : Araliaceae
Chemical Constitutes: Ginseng contains saponins, glycosides,
volatile oils, sterols, polysaccharides, minerals, vitamin-B. B, B12,
pantothenic acid and biotin.

Ginseng (शतावरी)
Uses: - Lowering the blood glucose level. - act as anti-inflammatory agent
- Reduce the hypertension - Act as anti-neoplastic agent
- It relieves stress and fatigue.

Ashwagandha
Biological Source : It consists of dried roots and stem bases of the plant Withania somnifera.
Family : Solanaceae
Chemical Constituents : It contains alkaloids and steroidal lactones.
- Alkaloids contain withanine, somniferine.
- It also contaion Somnine, tropine, two acyl steryl glucosides
sitoindosine-7 and sitoindosine-8.

Ashwagandha
Uses : - reduce blood sugar level - Antineoplastic agent
- Increase muscle mass - Anti-inflammatory agent
- Lower cholesterol - Improve brain function & memory
- Anti-arthritic agent - Hypotensive

Spirulina (हिरवे-हिळे शेवाळ)
Biological Source : It is blue green algae obtained from Spirulina maxima or Spirulina platensis.
Family : Oscillatoriaceae
Chemical Constitutes : It contains 50-70% proteins, 5-6% lipids.
- Lipids contain essential fatty acids like linoleic acid, oleic acid,
palmitic acid.

Spirulina (हिरवे-हिळे शेवाळ)
- It also contains glycolipids and sulfolipids, various vitamins like vitamin-B1, B2, B3.
- It contains iron and an enzyme superoxide di-mutase which has free radical scavenging effects and
help full in atherosclerosis, arthritis, diabetes, cataract stress and aging.
Uses: - Reduce high cholesterol - treats allergies
- Anti-diabetics agent - Anti-cancer agent
- improve muscle strength - Immune stimulant

HERB-DRUG & HERB FOOD INTERACTION
Drug Interaction
- Drug or herb interaction is a reaction between two or more drugs or between a drug and a food
beverage or supplement inside the body. A drug interaction can make the drug less effective increased
activity or cause unwanted side effects.
- Drug safety is a very basic and fundamental concept in medical practice. There is misbelief that
natural drugs are safe and lack toxicity. But this is not true as according to Ayurveda every material in the
universe is medicine and exert one or the other therapeutics effect if utilized properly but unwise use may
change the action of drug and its intensity which may be mild to severe or random.

- Some interaction as mentioned in Ayurveda are:
1. Herb-Herb Interaction:
- More the medications administered, greater is the chance of drugs interacting with each other. One
drug may potentiate the activity of another or inhibit its activity or serious unexpected side effects occur.
- e.g. Piper betel is contraindicated while taking Garcinia Morella.
2. Herb-Food Interaction:
- drugs interact with food/ beverages and can produce various side effects.
- e.g. Radish with milk

3. Disease related interaction:
- Sometimes drugs also interact with certain diseases where the disease alter the way a drug works.
- e.g. Haritaki (Terminalia chebula) contraindicated in pregnancy.
Mechanism of Herb-Drug/ Herb-Food Interaction
- Drug interactions can occur in several different ways starting from its absorption up to it elimination
from the body. Following are the various mechanisms by which drugs interact.

1. Pharmacodynamic Interaction:
- This occurs when two or more drugs administered together act at the similar receptor sites leading to
enhancement (additive or synergistic) effects or decreased (antagonistic) effects.
- A synergistic interaction may be beneficial for patients, but may also increase the risk of overdose.
- e.g. When warfarin is combined with coumarin containing herbs the anti-coagulant effects get
increased. Vitamin K-containing herbs can antagonize the effect of warfarin.

2. Pharmacokinetic Interaction
- There is modification in the effect of a drug during the process of absorption, distribution
metabolism or excretion of one or both of the drug compared with expected behavior of each
drug/herb/food when taken individually.
a) Absorption interactions:
- Some drugs can alter the absorption of another drug for example calcium can bind with some drugs
like tetracycline and HIV drug dolutegravir and block its absorption, hence such drugs should not be taken
along with milk and antacids.

b) Distribution interactions
- One or more drugs can compete with each other for plasma protein binding sites resulting in
displacement of one drug thereby increasing its blood levels and toxicity.
- E.g. Fenofibric acid (cholesterol lowering agent) and warfarin (blood thinner) when administered
together, compete for the protein binding sites leading to displacement and increased blood levels of
warfarin thus resulting in bleeding.
c) Metabolism interactions
- Enzymes in the liver such as cytochromes are responsible for metabolizing drugs and eliminating
them from the body.

- Some drugs may alter the enzyme levels or its activity resulting in fast or slow metabolism of drugs.
- E.g. Diltiazem (antihypertensive) inhibit the cytochrome enzyme responsible for metabolising
simvastatin (hypocholestremic) and elevates it's the blood levels resulting in serious liver and muscle side
effects.
d) Excretion interactions
- Some non steroidal anti inflammatory drugs (NSAIDs) like indomethacin may lower the kidney
function and reduce the excretion of lithium, a drug used for bipolar disorders. In such cases dose
adjustment is required.

HERB-DRUG INTERACTIONS
- Herb-drug interaction are drug interaction that take place between herbal medicine and
conventional drugs.
- These types of interaction may be more common that drug-drug interaction because herbal drug
contain numerous pharmacological active ingredient, while conventional drug contain only one.
- Herbs may mimic, increase or oppose the effect of drugs.
- The most commonly concerned herbs involved in such interaction are those containing magnesium,
calcium, iron.
- Even though herbal medicines are obtained from natural sources, their active ingredients are potent

chemicals which can give rise to herb-drug or herb-food interactions. Herbal supplements and
nutraceuticals are been purchased over the counter (OTC) and may be labelled as "All Natural" but that
does not mean they are always safe.
- However many different side effect of herbs have been reported including adverse event caused by
herbs to drug interaction.
- All herbal medicines are mixtures of more than one active ingredient such combination of many
substance increase the chances of interaction taking place.
- The probability of herbs to drug interaction is higher than drug to drug interaction because synthetic
drugs usually contain single chemical entites.

Table 1: Drug Interaction with herbal product.
Herbal Product Interacting Drugs
Ginkgo biloba Aspirin, warfarin, ticlopidine,
dipyridamole
Ephedra Caffeine, stimulants
Ginseng Warfarin
Kava Sedative, Sleeping pills, Antipsychotics,

HERB-FOOD INTERACTIONS
- Diet and daily life have a considerable impact on drugs. An herb-drug interaction is a condition in
which a herb affect the activity of a drug i.e. the effect are increased or decreased or they produce a new
effect that neither produce on its own.
- These may occur due to accidental misuse or dur to lack of knowledge about the active ingredient
present in the relevant herbs.
- Interaction between food and drugs may unintentionally reduce or increase the drug effect. Some
commonly used herbs fruits as well as alcohol may cause failure of the therapy and produce serious
changes in the patients health.

- Most food interaction are caused by food induced changes in the bioavailability of the herbs.
- Major side effect of some foods on herbal drugs include modification in absorption by fat, high
protein and fiber diet, treatment failure due to reduced bioavailability of the drug.
- Such interaction are commonly caused due to chelation of drug with components in food.
- This interaction can change pharmacokinetics and pharmacodynamic of a drug.
- The pharmacodynamic interaction may be additive, synergistic or antagonistic effect od drug.
- The gastrointestinal absorption of drug may be affected by the use of other agent which have a large
surface area upon which the drug can be absorbed, bind, alter gastric pH, alter gastrointestinal motility or
affect transport proteins.

- e.g. Alcohol is a common substance that may interfere with a verity of drugs. Interaction with drug
may cause nausea, vomiting, headaches, dizziness, change in behaviour and blood pressure changes. The
effect of many other drugs are increased when consuming alcohol. Consuming it with nitrates may casue
low blood pressure.
- Warfarin is blood thinner medication used to prevent blood cloth. It is dangerous to consume too
many food high in Vit K while taking warfarin. Excess levels of the vitamin will make warfarin and other
blood thinner less effective and increase risk of blood clots.

HERB-FOOD/ HERB FOOD INTERACTIONS
- Herbal supplements are not subject to review by the FDA and their use can often be risky when
taken along with other drugs or foods. Following are the general guidelines which help minimizing herb
drug or herb-food interaction.
a) Avoid taking mucilage containing herbs like isapgol, flax with other drugs, as mucilage can inhibit the
absorption of many drugs. Even mucilage containing drugs can alter the blood sugar levels which have to
be considered in case of diabetic patients.
b) Spicy substances such as ginger, capsicum, etc can enhance the absorption rate of some drugs, hence
they need to be taken one hour after drug administration.
c) Heart tonic herbs such as hawthorn/ digitalis / cactus, should be avoided when taking heart
medications.

HERB-FOOD/ HERB FOOD INTERACTIONS
d) Caffeine containing herbs like green tea, kola nut, coffee and herbal stimulants like ephedra should be
avoided when taking heart medications or mood altering drugs or antidepressants.
e) Avoid herbs or formulations containing liquorice when using diuretics like furosemide because liquorice
can cause potassium depletion from the body.
f) Green vegetables like broccoli, spinach, cabbage, etc which have high vitamin-K contene are reported to
interact with anticoagulant drugs as vit-K has coagulation promoting effects.
g) Grape fruit juice interacts with calcium channel blockers (antihypertensives), lipid lowering drugs.
psychiatric medications, oral contraceptives and anti-allergie medications. Grape juice modifies the
metabolism pattern of these drugs in the liver.

STUDY OF SOME COMMON HERBS AND
THEIR INTERACTIONS
Hypericum
- also known as St. Johns Wort.
- its extract are prepared from the aerial part of Hypericum Perforatum.
Side Effects:
- dry mouth, dizziness and confusion, allergic reaction, trouble sleeping,
vivid dream, nervousness, irritability, it might cause severe skin reaction to sun exposure.
Interaction:
- Hypericum along with alprazolam might decrease the effectiveness of alprazolam.

THEIR INTERACTIONS
Hypericum
- Hypericum might also increase sensitivity to sunlight. Taking it along with aminolevulinic acid might
increase the chances of sunburn or rashes on area of skin exposed to sunlight.
- Hypericum might decrease the effectiveness of amitriptyline by increasing breakdown of
amitriptyline in body.
- Hypericum along with birth control pill might decrease the effectiveness of birth control pill.
- Hypericum might increase breakdown of cyclosporine and decrease the effectiveness cyclosporine.
-Hypericum might decrease the effect of digoxin.

THEIR INTERACTIONS
Kava-Kava
- is an extract that is made from Piper methysticum.
- The name kava comes from the Polynesian word “awa” which mean bitter.
- Its active ingredient is kavalactone.
- Used for the treatment of anxiety, stress, insomnia,
depression respiratory tract infection, tuberculosis,
muscle pain and to prevent the cancer.

THEIR INTERACTIONS
Kava-Kava
Side Effect:
- produce sedation so do not take kava before driving.
- can cause liver damage.
Interaction:
- Kava should not be taken with drugs which act on nervous system such as barbiturates,
antidepressants, antipsychotics and alcohol.
- patients with Parkinson’s disease should not use kava product.

THEIR INTERACTIONS
Kava-Kava
- Kava has also reported to produce hepatotoxic effects when taken with some drugs.
- kava may also interaction with anti-cancer and birth control drug.

THEIR INTERACTIONS
Ginkgo biloba
- Extracts from the leaves of the ginkgo tree and belongs to family Ginkgoaceae.
- contain phenolic acids, proanthocyanidins, flavonoid glycoside, terpene trilactones.
- Used for the treatment of cancer, Alzheimer’s disease and high blood pressure.
Side Effect:
- produce stomach upset, headache, dizziness, constipation, allergic
skin reactions, causes the liver and thyroid cancer, bleeding.

THEIR INTERACTIONS
Ginkgo biloba
Interaction:
- should avoided with other herbal supplement that can affect blood clotting. This include capsicum,
clove, garlic, ginger, turmeric.
- Ginkgo is reported to decrease the antiviral effects of drugs used in HIV such as efavirenz or
indinavir.
- Ginkgo should be avoided in patients who are on anticonvulsants and antidiabetic drugs.

THEIR INTERACTIONS
Ginkgo biloba
- Ginkgo should be avoided in the condition such as infection, depression, asthama, cancer, high blood
pressure, high cholesterol, heart condition, psoriasis, rheumatoid arthritis.

THEIR INTERACTIONS
Ginseng
- It consists of roots of the plant Panax ginseng and other species of Panar.
- Ginseng contains saponins, glycosides, volatile oils, sterols, polysaccharides, minerals, vitamin-B,
pantothenic acid and biotin.
- used to improve thinking, concentration, memory, Alzheimer’s disease, physical stamina, depression,
anxiety.
Side Effect:
- trouble sleeping, breast pain, increase heart rate, headache, diarrhoea, itching, rash, mood change.

THEIR INTERACTIONS
Ginseng
Interaction:
- Ginseng decreases the effectiveness of warfarin (blood thinner) and increase the risk of clotting
hence it should be avoided while taking anticoagulants.
- Ginseng is also reported to decrease the activity of anti-hypertensive resulting in high blood
pressure.
- It is also reported to affect the activity of anti-diabetic drugs, hence should be avoided in such cases.
- Should be avoided in breast, ovarian and uterine cancer, mental disorder, insomnia.

THEIR INTERACTIONS
Garlic
- is an herb obtained from Allium sativum.
- contain active constitute allicin.
- used to treat high blood pressure, stomach cancer, colon cancer,
used for fungal infection and also used for high cholesterol.
Side effect:
- it causes the redness and swelling when applied to the skin, bleeding, nausea, vomiting, diarrhoea.
Interaction:
- Garlic is reported to affect the blood clotting hence should be avoided in patients taking blood

THEIR INTERACTIONS
Garlic
thinning agents like aspirin and warfarin.
- garlic should be avoided with birth control pill medicine, NSAIDs and cyclosporine.
- should be avoided in the infection, depression, asthma, cancer, high blood pressure, high cholesterol,
psoriasis, rheumatoid arthritis.

THEIR INTERACTIONS
Ephedra
- it is obtained from the plant Ephedra sinica.
- used for weight loss and obesity.
- also used for allergies, hay fever, asthama, headache, joint and bone pain
- it contain ephedrine, nor-ephedrine.
Side Effect:
- it is not safe for adults and children.
- dizziness, anxiety, irritability, headache, loss of appetite, nausea, vomiting.

THEIR INTERACTIONS
Ephedra
Interaction:
- Ephedra may reduce the effectiveness of antihypertensives and could rise the blood pressure.
- Ephedra should not be mixed with other central nervous system stimulants such as amphetamine and its
derivatives as it may enhance hyperactivity and produce serious conditions.
- Ephedra should be avoided with blood thinning medications such as aspirin and warfarin, as it may induce
bleeding.
- Ephedra may interact with anti depressants like imipramine, clomipramine, mortryptiline and mono
amino oxidase (MAO) inhibitors and enhance their effects.

THEIR INTERACTIONS
Ephedra
- Anti-diabetes drug interact with ephedra. Diabetes medication are used to lower blood sugar. By
increasing blood sugar, ephedra might decrease the effectiveness of diabetes medication.

THEIR INTERACTIONS
Pepper
- it is obtained from Piper nigrum.
- it contain a chemical called as piperine.
- used for pain, improve breathing, reduce inflammation and to improve
brain function
Side effect:
- might have a burning aftertaste.
- should be avoided during pregnancy, bleeding, diabetes.

THEIR INTERACTIONS
Pepper
Interaction:
- Piperine is reported to inhibit various cytochrome enzymes, resulting in increased blood level of
certain drugs like carbamazepine, midazolam, diclofenc, phenytoin and warfarin.
- Black pepper might increase the risk of bleeding when mixed with anticoagulants or blood thinning
drugs like aspirin, clopidogrel, heparin and warfarin.
- Black pepper might produce additive effect with antidiabetic drugs and increase the risk of
hypoglycaemia

THEIR INTERACTIONS
Pepper
- Black pepper might also increase the blood levels thereby enhancing the effects as well as side effects
of anti-cancer drugs, anti hypertensives, anti-convulsants and some antibiotics

HDT Unit 2: Nutraceuticals Global Market Overview And Growth Of Nutraceutical Segment

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HDT Unit 2: Nutraceuticals Global Market Overview And Growth Of Nutraceutical Segment