01.06.09
Posted in Herb-Drug Interactions, Herbs, Weatern Herbs at 9:33 pm by Dr. Pharm Tao
St John’s wort (Hypericum perforatum) - Phenprocoumon
Interaction effect:
Decreased AUC; Induction of CYP2C9; decreased anticoagulant effect
AUC = area under the concentration/time curve
Reference:
A Maurer, A Johne and S Bauer et al., Interaction of St John’s wort extract with phenprocoumon, Eur J Clin Pharmacol 55 (1999), p. A22.
Henderson, L., Yue, Q. Y., Bergquist, C., Gerden, B. & Arlett, P. St John’s wort (Hypericum perforatum): drug interactions and clinical outcomes. British Journal of Clinical Pharmacology 54 (4), 349-356.
Gordon JB. SSRIs and St. John’s wort: possible toxicity? Am Fam Phys 1998; 57: 950.
St John’s wort (Hypericum perforatum) - Cyclosporin; (Mycophenoloate, prednisone; Acetyldigoxin; Benzbromarone, betaxolol, amlodipine, pravastatin, magnesium; Azathioprine, corticosteroids; Prednisolone)
Interaction effect:
Decreased concentrations in serum; induction of CYP3A4 and the transport protein P-glycoprotein; reduced blood concentrations with risk of transplant rejection; immunosuppressive
Warning:
Check cyclosporin blood concentrations and stop SJW. Cyclosporin concentrations may increase on stopping SJW. The dose of cyclosporin may need adjusting.
Reference:
S Bon, K Hartmann and M Kuhn, Schweitzer Apothekerzeitung 16 (1999), pp. 535–536.
Henderson, L., Yue, Q. Y., Bergquist, C., Gerden, B. & Arlett, P. St John’s wort (Hypericum perforatum): drug interactions and clinical outcomes. British Journal of Clinical Pharmacology 54 (4), 349-356.
Barone GW, Gurley BJ, Ketel BL, Abul-Ezz Sr. Herbal supplements: a potential for drug interactions in transplant recipients. Transplantation 2001; 71: 239- 241.
Karliova M, Treichel U, Malago M, et al. Interaction of Hypericum perforatum (St. John’s wort) with cyclosporin A metabolism in a patient after liver transplantation. J Hepatol 2000; 33: 853-855.
Mai I, Kruger H, Budde K et al. Hazardous pharmacokinetic interaction of Saint John’s wort (Hypericum perforatum) with the immunosuppressant cyclosporin. Int J Clin Pharm Ther 2000; 38: 500-502.
Breidenbach Th, Hoffmann MW, Becker Th, et al. Drug interaction of St. John’s wort with ciclosporin. Lancet 2000; 355: 1912.
Ruschitzka F, Meier PJ, Turina M, et al. Acute heart transplant rejection due to Saint John’s wort. Lancet 2000; 355: 548-549.
Yue Q-Y, Bergquist C, Gerden B. Safety of St. John’s wort (Hypericum perforatum). Lancet 2000; 355: 576-577.
Gordon JB. SSRIs and St. John’s wort: possible toxicity? Am Fam Phys 1998; 57: 950.
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01.05.09
Posted in Herb-Drug Interactions, Herbs, Weatern Herbs at 9:30 pm by Dr. Pharm Tao
St John’s wort (Hypericum perforatum) - Nefazodone
Interaction effect:
Mild serotonin syndrome; nausea, vomiting, restlessness
Reference:
MS Lantz, E Buchalter and V Giambanco, St John’s Wort and antidepressant drug interactions in the elderly, J Geriatr Psychiatr Neurol 12 (1999), pp. 7–10.
St John’s wort (Hypericum perforatum) - Theophylline; (Frusemide, potassium, morphine, zolpidem, valproic acid, ibuprofen, amitriptyline, albuterol, prednisolone, zafirlukast, triamcinolone)
Interaction effect:
Decreased theophylline concentrations; induction of CYP1A2; reduced blood concentrations and possible loss of control of asthma or chronic airway limitation
Warning:
Check theophylline concentrations and stop SJW. Theophylline concentrations may increase on stopping SJW. The dose of theophylline may need adjusting.
Reference:
A Nebel, BJ Schneider, RK Baker and DJ Kroll, Potential metabolic interaction between St John’s Wort and theophylline, Ann Pharmacother 33 (1999), p. 502.
Henderson, L., Yue, Q. Y., Bergquist, C., Gerden, B. & Arlett, P. St John’s wort (Hypericum perforatum): drug interactions and clinical outcomes. British Journal of Clinical Pharmacology 54 (4), 349-356.
St John’s wort (Hypericum perforatum) - Digoxin
Interaction effect:
Decreased AUC, decreased peak and trough concentrations; induction of transport protein P-glycoprotein; reduced blood concentrations and possible loss of control of heart rhythm or heart failure
AUC = area under the concentration/time curve
Warning:
Check digoxin concentrations and stop SJW. Digoxin concentrations may increase on stopping SJW. The dose of digoxin may need adjusting.
Reference:
A Johne, J Brockmöller and S Bauer et al., Pharmacokinetic interaction of digoxin with an herbal extract from St John’s wort (Hypericum perforatum), Clin Pharmacol Ther 66 (1999), pp. 338–345.
Henderson, L., Yue, Q. Y., Bergquist, C., Gerden, B. & Arlett, P. St John’s wort (Hypericum perforatum): drug interactions and clinical outcomes. British Journal of Clinical Pharmacology 54 (4), 349-356.
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01.04.09
Posted in Herb-Drug Interactions, Herbs, Weatern Herbs at 10:04 pm by Dr. Pharm Tao
St John’s wort (Hypericum perforatum) - Paroxetine
Interaction effect:
Lethargy/incoherence; serotonin syndrome (akithisia, hyperreflexia, diaphoresis, hypertension, tachycardia)
Warning:
Probably additive effects only
Reference:
JB Gordon, SSRIs and St John’s wort: possible toxicity?, Am Fam Phys 57 (1998), p. 950.
Waksman JC, Heard K, Joliff H, et al. Serotonin syndrome associated with the use of St. John’s wort (Hypericum perforatum) and paroxetine (Abstract). Clin Toxicol 2000; 38 (5): 521.
St John’s wort (Hypericum perforatum) - Trazodone
Interaction effect:
Mild serotonin syndrome
Reference:
K Demott, St John’s wort tied to serotonin syndrome, Clin Psychiatry News 26 (1998), p. 28.
St John’s wort (Hypericum perforatum) - Sertraline; (Testosterone; Insulin)
Interaction effect:
Mild serotonin syndrome; mania; dizziness, nausea, vomiting, headache
Warning:
Probably additive effects only
Reference:
MS Lantz, E Buchalter and V Giambanco, St John’s Wort and antidepressant drug interactions in the elderly, J Geriatr Psychiatr Neurol 12 (1999), pp. 7–10.
Barbanel DM, Yusufi B, O’Shea D, Bench CJ. Mania in a patient receiving testosterone replacement post-orchidectomy taking St. John’s wort and sertraline. J Psychopharmacol 2000; 14: 84-86.
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