Pseudohypericin pharmacokinetics

Brockmoller J, Reum T, Bauer S, Kerb R, Htibner WD, Roots I. (1997). Flypericin and pseudohypericin pharmacokinetics and effects on photosensitivity in humans. Pharmacopsychiatry. 30(suppl 2) 94-101. 

The pharmacokinetics of hypericin and pseudohypericin piasma have been studied as weii (Brockmoiier et ai. 1997). Human subjects receiving piacebo, or 900, 1800, or 3600 mg of a standardized hypericum extract (LI 160), which contained 0, 2.81, 5.62, and 11.25 mg of totai hypericin and pseudohypericin, achieved maximum total plasma concentrations at 4 hours (0.028, 0.061, and 0.159 mg/L, respectively). The half-lives of absorption, distribution, and elimination were 0.6, 6.0, and 43.1 hours, respectively, using 750 pg of hypericin, and are slightly different for 1578 pg of pseudohypericin (1.3, 1.4, and 24.8 hours, respectively) (Kerb et ai. 1996). The systemic availability of the hypericum extract LI 160 is between 14 and 21%. Comparable results are found in another study using LI 160 (Staffeldt et ai. 1994). Long-term dosing of 3 x 300 mg per day showed that steady-state levels of hypericin are reached after 4 days. 

Kerb R, Brockmoiier J, Staffeldt B, Ploch M, Roots I. (1996). Single-dose and steady-state pharmacokinetics of hypericin and pseudohypericin. Antimicrob Agents Chemother. 40(9) 2087-93. Kim HL, Streltzer J, Goebert D. (1999). St. John s wort for depression a meta-analysis of well-defined clinical trials. J Nerv Ment Dis. 187(9) 532-38. 

Staffeldt B, Kerb R, Brockmoller J, Ploch M, Roots I. (1994). Pharmacokinetics of hypericin and pseudohypericin after oral intake of the hypericum perforatum extract LI 160 in healthy volunteers. J Geriatr Psychiatry Neurol. 7(suppl 1) S47-53. 

Single- and multiple-dose pharmacokinetic studies with extracts of SJW were performed in rats and humans, which focused on the determination of plasma levels of the naphthodianthrones hypericin and pseudohypericin and the phloroglucinol derivative hyperforin. Results from pharmacokinetic... 

A placebo-controlled, randomized clinical trial with monitoring of hypericin and pseudohypericin plasma concentrations was performed to evaluate the increase in dermal photosensitivity in humans after application of high doses of SJW extract (Table 2) (73). The study was divided into a single-dose and a multiple-dose part. In the single dose crossover study, each of the 13 volunteers received either placebo or 900, 1800, or 3600 mg of the SJW extract LI 160. Maximum total hypericin plasma concentrations were observed about four hours after dosage and were 0, 28, 61, and 159ng/mL, respectively. Pharmacokinetic parameters had a dose relationship that appeared to follow linear kinetics (73). 

Animal studies Early pharmacokinetic studies in mice report that maximum plasma concentrations of hypericin and pseudohypericin were reached at six hours and were maintained for at least eight hours. The aqueous-ethanolic SJW extract used in this study contained 1.0 mg of hypericin (77). 

Kerb R, Brockmoeller J, Staffeldt B, Ploch M, Roots I. Single-dose and steady state pharmacokinetics of hypericin and pseudohypericin. Antimicrob Agents Chemother 1996 40 2087-2093. 

Stock S, Hoelzl J. Pharmacokinetic tests of (14C)-labeled hypericin and pseudohypericin from Hypericum perforatum and serum kinetics of hypericin in man. Planta Med 1991 57 A61. 

Two pharmacokinetic studies have examined the pharmacokinetics of hypericin and pseudohypericin (41,42). Standardized hypericum extract LI 160 (Jarsin 300 , Lichtwer Pharma GmbH, Berlin) was used in both trials. In Part I of the studies, subjects in both trials were administered a single dose of either 300, 900, or 1800 mg of the extract (one, three, or six coated tablets) at 10- to 14-day intervals. Each dose contained 250, 750, or 1500 p.g of hypericin and 526, 1578, or 3156 p,g of pseudohypericin, respectively. The doses were administered on an empty stomach in the morning after a 12-hour fast. Subjects fasted for an additional 2 hours after administration. Multiple plasma levels of hypericin and pseudohypericin were measured for up to 120 hours after administration. In addition, urine samples were collected in the study performed by Kerb and colleagues. After a 4-week washout from Part I, subjects were given one coated tablet containing 300 mg of hypericum extract three times a day (8 am, 1 pm, and 6 pm) before meals for 14 days. Blood samples were obtained over the 2-week dosing period. 

Due to their complex composition the pharmacokinetic assessment of herbal medications generally imposes serious technical and regulatory problems. As the active principle(s) of plant extracts are often not known it is difficult to decide which constituent(s) should actually be studied [218]. In the absence of a well defined therapeutically relevant chemical entity, characteristic constituents of herbal preparations are frequently employed for the purpose of standardization. Correspondingly, pharmacokinetic evaluations of Hypericum extracts have almost exclusively been based on the analysis of the naphthodianthrones hypericin 1 and pseudohypericin 2 which represent typical products of members of the genus Hypericum and are considered to be involved in some of their clinical effects. 

Pharmacokinetic evaluations of hypericin 1 and pseudohypericin 2 in experimental animals are restricted to studies in mice. Following intravenous injection of 17.5 mg/kg of synthetically prepared hypericin peak concentrations of 27.8 pg/ml were measured at 10 min and decreasing values could be followed for a period of 240 h (10 ng/ml). The data were well adjusted to a two-compartment model with a distribution phase (ti/2a) of 2 h and an elimination half life (ti/2(3) of 38.5 h. The volume of... 

Table 3. Pharmacokinetic Parameters of Hypericin 1 and Pseudohypericin 2 After Oral Administration of 900 mg of a Methanolic Hypericum extract to Human Volunteers...

St John s wort modestly increased the clearance of single-dose carbamazepine, but had no effect on multiple-dose carbamazepine pharmacokinetics. Carbamazepine does not appear to significantly affect the pharmacokinetics of hypericin or pseudohypericin (constituents of St John s wort). St John s wort is predicted to reduce the blood levels of phenytoin and phenobar-bital, but this awaits clinical confirmation. 

A placebo-controlled study in healthy subjects taking St John s wort (LI160, Lichtwer Pharma) 300 mg three times daily found that, apart from a modest 25% increase in the AUC of pseudohypericin, cimetidine 1 g daily (in divided doses) did not significantly affect the pharmacokinetics of either the hypericin or pseudohypericin constituents of St John s wort. The available evidence therefore suggests that cimetidine is unlikely to affect the dose requirements of St John s wort. ... 

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