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Review Article

AAM. 2015; 4(1-2): 24-32


Integrative Approach in Management of Anti-Tubercular Drug Induced hepatotoxicity

Sarita Mahendra Kapgate, Abhijit Bajirao Patil.




Abstract

About one third of the world’s population is suffering from latent TB and roughly 9 million cases of active TB
emerge annually resulting in 2-3 million deaths. The most populated nations like India and China are on alarming
bomb. Combination of four drug chemotherapy is recommended to attain a successful cure containing Isoniazid,
Rifampicin and Pyrazinamide with or without ethambutol. But drug induced hepatotoxicity is a potential adverse
effect associated with anti-tuberculosis treatment (ATT). To reduce the hepatotoxicity due to ATT,the popular
measure is stoppage of causative drugs along with some vitamin supplementations.
The integrative approach to use medicinal herbal drugs mentioned inAyurvedawith proven hepato-protective
activity may give solution of this problem. It is proved that some herbs are having activities like membrane
stabilizing, anti-oxidative and CYP2E1 inhibitory effectsagainst pathology ofhepatotoxicity.
The critical study of classics of Ayurveda revealed that the herbs prescribed for GaravishajanyaVishaktata
withtiktarasa, having action on Raktavahasrotas along with Yakritagamitvamay be used as hepatoprotective
agent in the management of hepatotoxicity caused due to ATT. Preclinical and clinical studies are awaited to
prove this hypothesis.

Key words: Anti-tubercular drugs, Adhatoda vasica , Azadirachta indica, Tricosansanthes dioica , Terminallia chebula , Curcuma longa , Berberis aristata






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