Table 3 Overview of therapeutic uses and drug interactions of market-approved DBCLS from the Schisandra genus

Hepatoprotective effects

Bicyclol

Inhibition of hepatocyte apoptosis

No noticeable side effects

Increases hepatic heat shock proteins

[149, 150]

Anticancer activity on HepG2 cells

Cell cycle inhibition autophagy initiation

Inhibits HepG2 cell proliferation,

Decreases levels of several key proteins involved in cell cycle and proliferation

[151]

Anticancer activity on renal cancer/carcinoma cell

Apoptosis initiation

Cell cycle arrest

Increases oxidative stress in cancer cells

[152]

Hepatocellular carcinoma

Mice model

Significant reduction in liver tumors; 100% hepatoma and 50% hepatocellular carcinoma in control group

[153]

Hepatoprotective and anticancer

ICR mice model with cisplatin

Reduces cisplatin-induced liver tissue damage. Enhances liver enzymes

[154]

Multidrug resistance

In vitro studies

Reduces resistance to vincristine and adriamycin in cancer cell lines

[155]

Anti-transformative effects

Inhibition of WB-F344 cell transformation

Inhibits malignant transformation of cells

[151]

Combination therapies

Wuzhi capsules

Co-administered with methotrexate

Affects Methotrexate pharmacokinetics, suggesting potential to reduce inflammation in immunosuppressive therapies

[152]

Nephrotoxic and hepatotoxic effects

Co-administered with cyclophosphamide

Potentially attenuates side effects of cyclophosphamide

Alters pharmacokinetics to increase drug efficacy

[153]

Drug interactions

Co-administered with cyclosporine A, paclitaxel, tacrolimus

Affects blood levels of administered drugs

May influence absorption and first-pass metabolism, increasing the oral bioavailability of tacrolimus

[154, 155]