Summary of Clinical Information

(from Memorial Sloan-Kettering Cancer Center)

Traditionally, Sho-saiko-to is used to treat fever, malaria, gastrointestinal disorders and chronic liver diseases. A prescription form has been used extensively in Japan, predominantly for hepatitis. Sho-saiko-to and its isolated chemical components demonstrate marked antiproliferative effects on hepatoma lines and ovarian cancer cell lines. Morphological analysis of cells grown in the presence of Sho-saiko-to show evidence of apoptosis. Sho-saiko-to has been shown to prevent liver injury and promote liver regeneration in animal models and to enhance various aspects of immune function, including effects on killer cells, interleukins, interferon and macrophages. Data also indicate that Sho-saiko-to causes enhancement of granulocyte colony-stimulating factor.

Although Sho-saiko-to has a good safety profile, its use has been associated with interstitial pneumonitis. It should only be used under the supervision of a qualified practitioner. Clinical studies are currently underway to determine whether Sho-saiko-to can increase survival in patients with liver cancer and to evaluate its therapeutic effect on hepatitis C.

FOOD SOURCES

Some of the ingredients, such as jujube, ginger and licorice, are commonly found in Asian recipes.

CONSTITUENTS

Sho-saiko-to is a mixture of seven botanicals:

• Bupleurum root (Chai hu)
• Pinellia tuber (Ban xia)
• Scutellaria root (Huang qin)
• Ginseng (Ren shen)
• Jujube (da zao)
• Licorice (Gan cao)
• Ginger (Sheng jiang)

A number of pharmacologically active components have been isolated including:

• Baicalin
• Baicalein
• Glycyrrhizin
• Saikosaponins
• Ginsenosides
• Wogonin
• Gingerols  

PHARMACOKINETICS

Due to the complexity of this formula, only limited data is available. One study indicates that the serum concentration of glycyrrhizin after a normal daily dose is 1.2 mcg/ml.

WARNINGS

Sho-saiko-to may cause interstitial pneumonitis, a potentially fatal condition. Concurrent use of interferon may increase this risk.

CONTRAINDICATIONS

Women who are nursing or pregnant and patients currently undergoing interferon treatment should not take Sho-saiko-to.

ADVERSE REACTIONS

Sho-saiko-to related pneumonitis has been reported in 74 patients (approximately 1 in 20,000).

DRUG INTERACTIONS

Anticoagulants / Antiplatelets: Theoretically, SST may cause additive effects when administered concurrently.
Interferon: Concurrent use may increase the risk of interstitial pneumonitis.
Monoamine oxidase inhibitors (MAOIs): Some ingredients, such as ginseng and licorice, may potentiate activity of MAOIs.

LAB INTERACTIONS

May affect AST/ALT

For more click here to be linked to Memorial Sloan-Kettering Cancer Center The Integrative Medicine Service

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