Screening for Potential Pathways of Drug-Supplement Interactions Between Ahcc® and Common Medications

Rachel E. Carlson , Anjali Gaikwad , Lata Mathew , Judith A.Smith*

AHCC® is a standardized extract of cultured Lentinula edodes mycelia. It is utilized for its proposed immunomodulatory and anti-tumor

effects in conjunction with chemotherapy agents, as general immune support and even in supporting clearance of chronic viral infections such as the human papillomavirus (HPV). With the integration of natural supplements becoming more common in the healthcare arena across all disciplines, it is important to review the safety of use of supplements like AHCC® in combination with common medications, including possible drug-supplement interactions. Overall, ex vivo metabolism studies and confirmatory animals suggest AHCC does not  interact with majority of the drug metabolism pathways. However, these studies did also suggest that AHCC® has induction effects in the cytochrome P450 (CYP450) 2D6 metabolism pathway and of aromatase inhibitor activity. In addition, AHCC® did exhibit potential inhibitor effects in the quinone oxidoreductase (QOR) phase II hepatic metabolism pathway, and potential induction effects of uridine diphosphate (UDP) – glucuronosyltransferase (UGT) 1A3 and 1A6 pathways. The primary objective of this manuscript is to synthesize and review data on proposed phase I and phase II hepatic metabolism pathways of AHCC in discuss the safe use of AHCC® in combination with most common medications, including chemotherapy.