Simultaneous Quantitation of Multiple Antihypertensive Drugs in Plasma: A Comprehensive Review with Focus on Herb–Drug Interactions

The common practice of using herbal medicines in combination with prescribed antihypertensive treatments highlights the urgent requirement for precise and effective concurrent determination of multiple cardiovascular drugs in plasma. Herb– drug interactions (HDIs) can profoundly impact pharmacokinetic factors i.e., Cₘₐₓ and AUC via mechanisms such as CYP450 modulation and transporter regulation, with severe implications varying from failure of therapy to toxicity. Versatile analytical methods using mostly LCMS/MS support high-throughput and sensitive quantification of numerous antihypertensive drugs from plasma matrices. This paper integrates present methodologies to carryout simultaneous drug quantitation, summarizes mechanistic findings and evidence from HDI research, and discusses future directions such as AI-based decision-support tools and the necessity for clinical validation frameworks.