Plecranthus barbatus or Forskolin is an Indian herb which is being used in Ayurvedic medicine for centuries for the treatment of a number of diseases. Forskolin has proven to be highly beneficial in the treatment of ophthalmic disorders like glaucoma, skin allergies, urinary tract disorders, arthritis, osteoporosis, cardiovascular diseases like angina, heart attack, and heart failure, respiratory disorders like asthma and COPD i.e. Chronic Obstructive Pulmonary Disease, and gastrointestinal disorders like gastric spasms, nausea, and vomiting.
However, despite being a beneficial therapeutic agent, there are certain harmful effects associated with Forskolin when it’s used in combination with anti-hypertensive and blood-thinning medicines. Let’s take a look at the working of pure natural Forskolin and how it can negatively interact with different anticoagulants and anti-hypertensive agents.
Working of Forskolin
Forskolin works by increasing the production of an enzyme adenylate cyclase. This enzyme is a potent precursor of cAMP i.e. cyclic adenosine monophospahte. This c AMP goes through the process of double phosphorylation and two phosphate groups are attached to its structure. This double phosphorylation of cAMP leads to the formation of ATP i.e. adenosine triphosphate. ATP is the major energy resource of the body and it’s required for the proper functioning of a number of metabolic and cellular processes .
Once this ATP is released in the body, it’s taken up by the skeletal tissues, cardiac tissues, and smooth muscles for their improved functioning. This ATP has a massive impact on smooth muscle activity and causes significant relaxation of smooth muscles. Our blood arteries are also made up of smooth muscles. Hence, with increased relaxation of smooth muscles, the blood arteries are dilated and the flow of blood through these arteries is increased. Also, since the diameter of blood arteries is increased, the blood exerts less pressure on the walls of these arteries which generates hypotensive effects i.e. decreased blood pressure .
Forskolin also decreases the formation of blood clots via two mechanisms. Forskolin increases the process of lipolysis i.e. breakdown and removal of lipids. Because of this action, it decreases the levels of harmful cholesterol i.e. LDL (low density lipoprotein) in the body. When the levels of LDL are decreased in the blood, the blood regains its normal thickness or viscosity and the formation of blood clots is prevented.
Forskolin also delays the formation of blood clots through dilation of blood capillaries. When blood capillaries are constricted, it leads to atherosclerosis i.e. arterial blood clot formation. This happens because when viscous blood passes through narrow capillaries; its flow is hindered and restricted which leads to clot generation. Hence, with the dilation of blood capillaries, blood easily passes through them and clot formation is prevented.
Different Antihypertensive Agents and Their Negative Interaction with Forskolin
The different types of antihypertensive agents include Beta-Blockers, Calcium-Channel Blockers, ACE Inhibitors I.E. Angiotensin-Converting Enzyme Inhibitors, and Diuretics.
Diuretics decrease the blood pressure by increasing the removal of salt and water from the body through renal elimination. These drugs act on kidneys and stop the excessive re-absorption of minerals and water through the loop of henle and collecting duct. Hence, the concentration of minerals in the blood is decreased which leads to decreased blood pressure. Most commonly used diuretics include spironolactone, triamterene, hydrochlorothiazides, and furosemide.
Beta-blockers work on the beta-adrenergic receptors and decrease their ability to bind with the excitatory hormones i.e. epinephrine and adrenaline. This decreases the effect of these hormones on the cardiovascular system. These hormones have a negative effect on heart and increase cardiac contractions, thereby leading to increased heart rate and blood pressure. Hence, with decreased activity of epinephrine and adrenaline, the cardiac tissues are relaxed and there’s a massive decrease in heart rate, palpitations, and blood pressure. Commonly used beta blockers include atenolol, propranolol, timolol, carvedilol, and nadolol.
ACE inhibitors work by inhibiting the conversion of an enzyme angiotensin-I into angiotensin-ll. Angiotensin-ll is a potent vasoconstrictor. This enzyme contracts the blood vessels due to which the pressure on the inner walls of these vessels increases as the blood passes through them. This causes increased blood pressure in an individual. Hence, with the inhibition of angiotensin-ll, the blood vessels are relaxed and blood pressure is decreased. Commonly used ACE inhibitors include quinapril, ramipril, captopril, benazepril, and fosinpril.
When Forskolin is used in combination with these drugs, the combined anti-hypertensive effect can induce unexpected mild to severe hypotension in an individual. This hypotension can cause extreme dizziness, lightheadedness, disorientation and shallow breathing or hyperventilation. In extremely severe cases it can even lead to life-threatening hypotensive crisis.
Anticoagulants and Their Harmful Interaction with Forskolin
Anticoagulants or blood-thinning agents are those therapeutic agents which prevent the blood clot formation by decreasing the activity of coagulation factors. They are used for the treatment of thromboembolic and thrombotic disorders which include pulmonary embolism, myocardial infarction, and deep vein thrombosis. Most commonly used anticoagulants include warfarin and heparin.
Warfarin is an oral anticoagulant which inhibits the working of vitamin K in the body. Vitamin k activates coagulating factors ll, Vll, and X. Hence, with the inhibition of vitamin k, the activity of these coagulating factors is decreased, thereby preventing the blood clot formation.
Heparin is an intravenous anticoagulant which activates a chemical antithrombin lll in the body. This chemical inhibits factor Xa and thrombin, which are necessary to complete the blood clotting cascade. With the inhibition of these chemicals, the clotting cascade remains incomplete and blood clotting is prevented.
When Forskolin in combined with these agents, so the synergistic effect leads to excessive thinning of blood. This blood thinning can cause both internal and external bleeding and leads to harmful hemorrhages, nose bleeds, and bruising.
What Can We Conclude?
On the basis of the abovementioned details, it can be concluded that Forskolin should never be used in combination with any antihypertensive or blood-thinning medication. Also, self-medication of Forskolin is strongly prohibited. It should only be used after proper recommendation from a registered medical practitioner to ensure maximum safety of the patient.