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Human pharmacokinetics and drug interaction potential of GuHong: an intravenous herbal formulation for managing ischemic stroke
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Qiu-Yue Wang1, 2, Zhen-Zhen Ma1, 2, Jia-Ye Yuan1, 2, Guo-Li Yue1, 2, Yun-Fei Feng2, 3, Xiao-Yan Xia2, 3, Wei-Wei Jia2, Fei-Fei Du2, Feng-Qing Wang2, Xuan Yu2, Chen Cheng2, Yü-Hong Huang4, Xiao-Kai Wang5, Yi-Mei Zeng6, Yan-Fen Li4, Zi-Jing Song6, Jun-Ling Yang1, 2, 3, 7, *, Chuan Li1, 2, 3, 6, 7, *
Acupuncture and Herbal Medicine | 2025, 5(2) : 173 - 192
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Acupuncture and Herbal Medicine | 2025, 5(2): 173-192
• Original Articles •
Human pharmacokinetics and drug interaction potential of GuHong: an intravenous herbal formulation for managing ischemic stroke
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Qiu-Yue Wang1, 2, Zhen-Zhen Ma1, 2, Jia-Ye Yuan1, 2, Guo-Li Yue1, 2, Yun-Fei Feng2, 3, Xiao-Yan Xia2, 3, Wei-Wei Jia2, Fei-Fei Du2, Feng-Qing Wang2, Xuan Yu2, Chen Cheng2, Yü-Hong Huang4, Xiao-Kai Wang5, Yi-Mei Zeng6, Yan-Fen Li4, Zi-Jing Song6, Jun-Ling Yang1, 2, 3, 7, *, Chuan Li1, 2, 3, 6, 7, *
Affiliations
  • 1Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
  • 2State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
  • 3University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing, China
  • 4Second Affiliated Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin, China
  • 5Tonghua Guhong Pharmaceutical Tonghua, China
  • 6Zhongshan Institute for Drug Discovery, Zhongshan, China
  • 7China-Serbia "Belt and Road" Joint Laboratory for Natural Products and Drug Discovery, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
Published: 2025-06-25 doi: 10.1097/HM9.0000000000000155
Outline
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Objective:

Unlike for drug-drug interactions, rigorous guidelines for assessing herb-drug interactions are nonexistent. GuHong is an intravenous herbal formulation used as adjunct therapy for the management of ischemic stroke. This investigation aimed to evaluate its potential to precipitate pharmacokinetic drug interactions. To facilitate the potential assessment, a human multi-compound pharmacokinetic study, along with associated supportive studies, was conducted to pinpoint GuHong compounds for testing.

Methods:

After analyzing the chemical composition of GuHong, a pharmacokinetic study was conducted in healthy subjects who received GuHong intravenously to identify its significantly exposed compounds and their pharmacokinetics. In addition, supportive rat and in vitro studies were conducted to assess the hepatic and renal disposition of these compounds, including their metabolism and transport. The potential of GuHong to precipitate drug interactions was evaluated in vitro using significantly exposed compounds, which were tested for their effects on drug-metabolizing enzymes and drug transporters listed in the ICH M12 Guideline (2024), with a focus on inhibition and induction. Samples were analyzed by liquid chromatography-mass spectrometry.

Results:

A total of 54 constituents (0.01-27.18 μmol/day) derived from Carthamus tinctorius flowers (Honghua) and N-acetyl-L-glutamine (3,090 μmol/day) were detected in GuHong. Following intravenous administration of GuHong, hydroxysafflor yellow A emerged as the principal circulating compound from Honghua. Saffloquinoside D, kaempferol-3-O-rutinoside, kaempferol-3-O-sophoroside, 8-hydroxycinnamic acid-8-O-glucoside, coumaric acid-4-O-glucoside, and chlorogenic acid, also from Honghua, were detected but at low plasma levels. Hydroxysafflor yellow A, primarily eliminated via glomerular filtration-based renal excretion, exhibited the characteristics of an intravenous "hard drug." N-Acetyl-L-glutamine was another major circulating compound of GuHong and was eliminated through renal excretion and hydrolysis to L-glutamine. GuHong had a low potential to precipitate pharmacokinetic drug interactions.

Conclusions:

The low drug interaction potential of GuHong is advantageous for its use in the treatment of ischemic stroke in the context of polypharmacy. The methodology developed here can be applied to the study of other complex herbal medicines for their pharmacokinetic drug interaction potential.

Carthamus tinctorius  /  Drug interaction  /  GuHong injection  /  Hydroxysafflor yellow A  /  N-Acetyl-L-glutamine  /  Pharmacokinetics
Qiu-Yue Wang, Zhen-Zhen Ma, Jia-Ye Yuan, Guo-Li Yue, Yun-Fei Feng, Xiao-Yan Xia, Wei-Wei Jia, Fei-Fei Du, Feng-Qing Wang, Xuan Yu, Chen Cheng, Yü-Hong Huang, Xiao-Kai Wang, Yi-Mei Zeng, Yan-Fen Li, Zi-Jing Song, Jun-Ling Yang, Chuan Li. Human pharmacokinetics and drug interaction potential of GuHong: an intravenous herbal formulation for managing ischemic stroke[J]. Acupuncture and Herbal Medicine, 2025 , 5 (2) : 173 -192 . DOI: 10.1097/HM9.0000000000000155
  • National Natural Science Foundation of China Grants(82192912; 82074273)
  • National Key R&D Program ("Strategic Scientific and Technological Innovation Cooperation") Key Project(2022YFE0203600)
Year 2025 volume 5 Issue 2
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Article Info
doi: 10.1097/HM9.0000000000000155
  • Receive Date:2024-10-09
  • Online Date:2026-11-04
  • Published:2025-06-25
Article Data
Affiliations
History
  • Received:2024-10-09
  • Accepted:2025-04-14
Funding
National Natural Science Foundation of China Grants(82192912; 82074273)
National Key R&D Program ("Strategic Scientific and Technological Innovation Cooperation") Key Project(2022YFE0203600)
Affiliations
    1Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
    2State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
    3University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing, China
    4Second Affiliated Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin, China
    5Tonghua Guhong Pharmaceutical Tonghua, China
    6Zhongshan Institute for Drug Discovery, Zhongshan, China
    7China-Serbia "Belt and Road" Joint Laboratory for Natural Products and Drug Discovery, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China

Corresponding:

* Jun-Ling Yang E-mail:
Chuan Li, E-mail: .
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表12种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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