Licorice Botanical Dietary Supplements - Metabolism and Safety in Women

Study Overview
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Brief Summary
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Human safety studies will be carried out to test whether red clover botanical dietary supplements used by peri- and post-menopausal women are safe to use with Food and Drug Administration (FDA)-approved drugs. To test this, a red clover dietary supplement (previously tested in women at the University of Illinois at Chicago without any harmful effects) will be given with four selected FDA-approved drugs to determine if the Licorice supplement can increase or decrease how these medications are absorbed, metabolized and excreted by the human body. Preclinical studies predict that the licorice supplement might affect the metabolism or break down of these probe drugs.

Detailed Description
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At the start of a study, subjects will be administered low doses of a mixture of four FDA-approved drugs (caffeine, tolbutamide, dextromethorphan, and alprazolam), and serial blood samples will be drawn and analyzed for the concentration of each drug over time. Afterwards, participants will take the licorice dietary supplement twice daily for 14 days to allow for potential inhibition or induction of drug metabolizing enzymes and transporters. Thereafter, the same drugs will be taken again to obtain a second measure of drug concentrations in blood over time. Changes in the concentration-time curve values for each probe drug obtained before and after ingestion of the supplement would indicate that metabolism of the probe drugs is impacted by the licorice dietary supplement.

Official Title
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Licorice Botanical Dietary Supplements - Metabolism and Safety in Women

Conditions
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Food-drug Interaction

Intervention / Treatment
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* Dietary Supplement: Licorice
* Drug: Alprazolam 2 MG
* Drug: Caffeine 100 MG
* Drug: Tolbutamide 250 mg
* Drug: Dextromethorphan 30mg


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: healthy peri- and post-menopausal women ages 40 - 79 non-smokers no-significant medical conditions as assessed by subject-reported medical history, physical examination and blood and urine chemistry screens no medical condition that requires chronic use of medication Exclusion Criteria: known allergies or hypersensitivity to caffeine, dextromethorphan, sulfonylureas (tolbutamide), benzodiazepines, or licorice positive pregnancy test use of hormone therapy within 8 weeks of study initiation for oral agents, 4 weeks for transdermal or other topical agents use of caffeine products 7 days before study participation or during the study use of citrus products 7 days before study participation or during the study other prescription (with the exception of the Mirena® IUD) or non-prescription medicines within the 2 weeks prior to study initiation or during the study chronic diseases, such as inflammatory bowel disease, that could alter the absorption or metabolism of the probe substrates unwillingness to comply with study requirements current participation in another clinical trial CYP2D6 deficiency based on phenotyping at screening smoker licorice (whether as a botanical dietary supplement, candy, food, drink or otherwise) within the previous two weeks and during the study use of any dietary supplements within the last 2 weeks prior to study initiation and during the study extreme obesity (defined as >40 BMI) alcohol or drug abuse chronic diseases such as diabetes.

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 79 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: G.Glabra<br>single arm | Dietary Supplement: Licorice<br>* Experimental :G. glabra Licorice extract: 2 gelatin capsules (75 mg) per day for 14 days<br>* Other names: G. glabra;Drug: Alprazolam 2 MG<br>* probe substrate<br>* Other names: CYP3A4/5 substrate;Drug: Caffeine 100 MG<br>* probe substrate<br>* Other names: CYP1A2 substrate;Drug: Tolbutamide 250 mg<br>* probe substrate<br>* Other names: CYP2C9 substrate;Drug: Dextromethorphan 30mg<br>* probe substrate<br>* Other names: CYP2D6 substrate;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1. Area Under the Curve (AUC) | Concentration of probe drugs from blood draws during the 14-day intervention will be used to calculate area under the (extrapolated) concentration-time curve to determine any changes compared to pre-intervention. | baseline and 14 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1. Apparent Clearance | Concentration of probe drugs from blood draws during the 14-day intervention will be used to calculate apparent clearance of probe drug to determine any changes compared to pre-intervention. | baseline and 14 days | 
| 2. Peak Concentration | Concentration of probe drugs from blood draws during the 14-day intervention will be used to calculate peak concentration of probe drug to determine any changes compared to pre-intervention. | baseline and 14 days | 
| 3. Time for Peak Concentration | Concentration of probe drugs from blood draws during the 14-day intervention will be used to calculate time for peak concentration of probe drug to determine any changes compared to pre-intervention. | baseline and 14 days | 
| 4. Drug Half-life [Time Frame: baseline and 14 days] | Concentration of probe drugs from blood draws during the 14-day intervention will be used to calculate half-life of probe drug to determine any changes compared to pre-intervention. | baseline and 14 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Licorice