Quazepam wort

Kawaguchi A, Ohmori M, Tsuruoka S, Nishiki K, Harada K, Miyamori I, Yano R, Nakamura T, Masada M, Fujimura A. Drug interaction between St John s wort and quazepam. Br J Clin Pharmacol 2004 58 403-10. 

Clinically important, potentially hazardous interactions with amiodarone, amitriptyline, amoxapine, benzodiazepines, bepridil, clomipramine, clonazepam, clorazepate, delavirdine, desipramine, diazepam, dihydroergotamine, doxepin, ergotamine, fentanyl, flurazepam, imipramine, ixabepilone, lidocaine, lorazepam, methysergide, midazolam, nortriptyline, oxazepam, phenytoin, protriptyline, quazepam, quinidine, rifampin, ritonavir, sildenafil, St John s wort, temazepam, tricyclic antidepressants, trimipramine, vitamin E... 

Clinically important, potentially hazardous interactions with amlodipine, anisindione, anticoagulants, aprepitant, atorvastatin, barbiturates, benzodiazepines, butabarbital, carbamazepine, chlordiazepoxide, clarithromycin, clonazepam, dorazepate, corticosteroids, cyclosporine, dexamethasone, diazepam, dicumarol, erythromycin, ethotoin, felodipine, flurazepam, fluvastatin, fosphenytoin, isradipine, itraconazole, ketoconazole, lorazepam, lovastatin, mephenytoin, mephobarbital, midazolam, nicardipine, nifedipine, nimodipine, nisoldipine, oxazepam, pentobarbital, phenobarbital, pimozide, pravastatin, primidone, quazepam, rifampin, secobarbital, simvastatin, St John s wort, temazepam, warfarin... 

Clinically important, potentially hazardous interactions with alprazolam, astemizole, atazanavir, chlordiazepoxide, clonazepam, clorazepate, conivaptan, dasatinib, delavirdine, diazepam, dihydroergotamine, ergot alkaloids, estazolam, fentanyl, fesoterodine, flurazepam, halazepam, ixabepilone, lapatinib, methysergide, midazolam, pimozide, quazepam, rifapentine, sildenafil, solifenacin, St John s wort, temsirolimus, triazolam, vardenafil... 

Clinically important, potentially hazardous interactions with alfentanil, alfuzosin, alprazolam, amiodarone, amprenavir, aprepitant, astemizole, atazanavir, bepridil, buprenorphine, bupropion, carbamazepine, chlordiazepoxide, ciclesonide, clozapine, conivaptan, cyclosporine, cyproterone, dasatinib, diazepam, dihydroergotamine, ergot alkaloids, estazolam, eszopidone, etravirine, ezetimibe, fentanyl, fesoterodine, flecainide, flurazepam, fluticasone, halazepam, ivabradine, ixabepilone, ketoconazole, lapatinib, levothyroxine, meperidine, meptazinol, methysergide, midazolam, nifedipine, nilotinib, oral contraceptives, phenytoin, pimozide, piroxicam, propafenone, propoxyphene, quazepam, quinidine, ranolazine, rifabutin, rifampin, rifapentine, rimonabant, rivaroxaban, saquinavir, sildenafil, silodosin, simvastatin, solifenacin, St John s wort, tadalafil, temsirolimus, trabectedin, triazolam, vardenafil, voriconazole, zolpidem... 

St John s wort decreases the plasma levels of quazepam, although this did not reduce its effects in one study. Alprazolam appears not to interact, although this needs confirmation. The bioavailability of midazolam was reduced by long-term but not single doses of St John s wort... 

In a placebo-controlled study, 13 healthy subjects were given St John s wort (TruNature., hypericin content standardised at 0.3%) 300 mg three times daily for 14 days with a single 15-mg dose of quazepam on day 14. Although St John s wort did not affect the pharmacodynamic effects of quazepam it did decrease the quazepam AUC by 26% and the maximum plasma levels by 29%.This was attributed to the effects of St John s wort on the cytochrome P450 isoenzyme CYP3A4, by which quazepam is metabolised. ... 

In healthy volunteers orally administered a single dose of quazepam before or after oral administration of 900 mg St. John s wort daily for 14 days, a significant reduction in plasma levels of quazepam was observed after St. John s wort dosing. In subjective testing of volunteers, no significant effects of St. John s wort on quazepam activity were observed. Quazepam is metabolized by CYP3A4 (Kawaguchi et al. 2004). 

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