St.John’s wort

Potassium Competitive Acid Blockers The pregnane X receptor (PXR) is a promiscuous nuclear receptor, that has evolved to protect the body from toxic chemicals. It is activated by a wide variety of xenobiotics including several diugs like rifampicin, hyperforin ( the active ingredient of St. John s wort), clotrimazole and others. PXR heterodimerizes with the... 

None of the antidepressants should be administered with herbalpreparationscontaining St. John s wort because of the potential for adverse reactions. 

Numerousherbai diureticsare available as over-the-counter (OTQ products. Most plants and herbal extracts available as OTCdiureticsare nontoxic. However, most are either ineffective or no more effective than caffeine. The following are selected herbals reported to possess diuretic activity cetery, chicory, sassafras juniper berries St. John s wort, foxglove, horsetail, licorice, dandelion, digital is purpurea, ephedra, hibiscus parsley, and elderberry. 

St. John s wort Hypericum Antidepressant and Usually mild. May May decrease efficacy of... 

Traditional herbal and homeopathic remedies that are supplied as natural treatments for medical conditions or diseases are subject to regulation as drugs, for example St. John s wort. 

Hypericin, from Hypericum perforatum (St. John s wort)... 

Hypericum perforatum L. Hypericaceae (St John s Wort) Unknown... 

Another successful adaptation of the fully extended DFG S19 approach is the determination of, e.g., fenpyroximate in all type of berries by LC/MS/MS with APCI monitoring of positive ions directly in the S19 raw extract, and further the determination of trifluralin by LC/MS/MS with APCI monitoring of negative ions after performing a short SPE cleanup on an ion-exchange material. Similar approaches have used CC/MS/MS for, e.g., fenpropimorph and kresoxim methyl in St. John s Wort and peppermint. 

It is being recognized increasingly that regulation can have a positive impact on laboratory productivity.36 System suitability testing has been proposed as superior to and supplemental to calibration in the UV-VIS detector.37 Large variations in both response factor and in relative response factors were observed on different instruments. Even on the same instrument, UV-VIS spectra can be extremely dependent on solution conditions, as was observed in a separation of hypericin, the antidepressant extract of St. John s wort.38... 

Dextromethorphan, meperidine, and pentazocine ° Amphetamine, fenfluoramine, dexfenfluoramine, methylphenidate, and cocaine ° Sibutramine, St. John s wort, ondansetron, granisetron, dolasetron, and palonosetron... 

Conversely buprenorphine metabolism could by increased by carbamazepine, phenytoin, St. John s wort, efavirenz, and nevirapine, or any other CYP3A4 inducer the effects may be less than expected may need to increase buprenorphine dose. 

St. John s wort This herbal remedy may induce CYP3A4 the certainty of an interaction probably rests on the specific preparation being used, but caution would dictate that this herbal product should be avoided in those receiving methadone treatment withdrawal symptoms have been noted in patients taking methadone maintenance who have added St. John s wort to their drug regimen. 

St. John s wort Increase metabolism of COCs via induction of various cytochrome P-450 enzymes Decrease efficacy of COCs avoid use with COCs... 

CYP3A4 is highly inducible by a large variety of commonly prescribed and utilized synthetic drugs (e.g., carbamazepine) and plant products (e.g., St. John s wort) (Roby, Anderson et al, 2000), and at the same time also is potently inhibited by various other medications (e.g., terfenadine and ketoconazole) (Jurima-Romet, Crawford etal, 1994) as well as common foodstuffs (e.g., grapefruit juice) (Oesterheld 8c Kallepalli, 1997). Since individual and ethnic/cultural groups vary dramatically in their exposure to these inducers and inhibitors, it stands to reason that... 

Risperidone Aripiprazole 2D6 > 3A4 2D6, 3A4 Carbamazepine and phenytoin topiramate hypericum (St. John s Wort). Paroxetine, fluoxetine, sertraline (high dose) grapefruit juice 2D6 or 3A4 substrates acting as competitive inhibitors. 

Maprotiline, Moclobemide, Mianserin, Fluoxetine (Prozac), Paroxetine, Sertraline, Fluvoxamine, Citalopram, Venlafaxin (generic IR formulation and the brand Venlafaxine XR), Mirtazapine, Flupentixol-melitracen (Deanxit), Tianeptine, Extract of St. John s Wort, Buspirone Depression and anxiety... 

Lecrubier, Y., Clerc, G., Didi, R. Kieser, M. (2002). Efficacy of St. John s Wort extract WS 5570 in major depression a double-blind, placebo-controlled trial. Am. J. Psychiatry, 159, 1361-6. 

Schrader, E. (2000). Equivalence of St John s Wort extract (Ze 117) and fluoxetine a randomized, controlled study in mild-moderate depression. Int. Clin. Psychopharmacol., 15, 61-8. 

Synergy of therapeutic pharmacological effects St. John s Wort will induce serotonin syndrome when co-administered with SSRIs. 

St. John s wort, which has become very popular for the treatment of depression, has been shown to induce intestinal P-gp and intestinal and hepatic CYP3A4 in humans [140]. That mechanism explains the significant reduction in cyclosporin and anti-aids (e.g., indinavir) plasma concentrations. It is likely that similar effects will be noted with the compounds listed in Table 8 (although the effects noted in Table 8 are in the opposite direction of those seen in the presence of St. John s wort). 

D Durr, B Stieger, GA Kullak-Ublick, KM Rentsch, HC Steinert, PJ Meier, K Fattinger. St. John s wort induces intestinal />-glycoprotci n/M DR l and intestinal and hepatic CYP3A45. Clin Pharmacol Ther 68 598-604, 2000. 

A. Johne, J. Brockmoller, S. Bauer, A. Maurer, M. Langheinrich, and I. Root, Pharmacokinetic interaction of digoxin with an herbal extract from St. John s wort (Hypericum perforatum). Clin. Pharmacol. Ther., 66, 338-345 (1999). 

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