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Total coumarin extract (TCE) is a botanical extract derived from Radix Angelicae dahuricae (Baizhi), a traditional Chinese medicinal herb. It contains a variety of furanocoumarins, most notably imperatorin and isoimperatorin. TCE is primarily investigated for its synergistic effects when co-administered with other drugs, such as ligustrazine, in the treatment of migraine. Its mechanism involves the inhibition of several cytochrome P450 (CYP450) enzymes, including CYP1A2, CYP2C9, CYP2D6, and CYP3A4, which reduces the metabolism of co-administered substrates, thereby increasing their plasma concentration and prolonging their therapeutic effect. Additionally, TCE has demonstrated direct anti-migraine activity by modulating levels of calcitonin gene-related peptide (CGRP), nitric oxide (NO), and endothelin.
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