David Baxter PhD
Late Founder
Clinical drugs that interact with St. John's wort and implication in drug development
by Di YM, Li CG, Xue CC, Zhou SF
Curr Pharm Des. 2008;14(17):1723-42.
August 9, 2008
St. John's wort (Hypericum perforatum, SJW) is one of the most commonly used herbal antidepressants for the treatment of minor to moderate depression.
A major safety concern about SJW is its ability to alter the pharmacokinetics and/or clinical response of a variety of clinically important drugs that have distinctive chemical structure, mechanism of action and metabolic pathways. This review highlights and updates the knowledge on clinical interactions of prescribed drugs with SJW and the implication in drug development.
A number of clinically significant interactions of SJW have been identified with conventional drugs, including
A comprehensive understanding of clinical drugs that interact with SJW has important implications in drug development. New drugs may be designed to minimize interactions with SJW; and new SJW formulations may be designed to avoid drug interactions. Further clinical and mechanistic studies are warranted to explore the interaction of SJW with other important drugs and the potential clinical impact.
Abstract
by Di YM, Li CG, Xue CC, Zhou SF
Curr Pharm Des. 2008;14(17):1723-42.
August 9, 2008
St. John's wort (Hypericum perforatum, SJW) is one of the most commonly used herbal antidepressants for the treatment of minor to moderate depression.
A major safety concern about SJW is its ability to alter the pharmacokinetics and/or clinical response of a variety of clinically important drugs that have distinctive chemical structure, mechanism of action and metabolic pathways. This review highlights and updates the knowledge on clinical interactions of prescribed drugs with SJW and the implication in drug development.
A number of clinically significant interactions of SJW have been identified with conventional drugs, including
- anticancer agents (imatinib and irinotecan),
- anti-HIV agents (e.g. indinavir, lamivudine and nevirapine),
- anti-inflammatory agents (e.g. ibuprofen and fexofenadine),
- antimicrobial agents (e.g. erythromycin and voriconazole),
- cardiovascular drugs (e.g. digoxin, ivabradine, warfarin, verapamil, nifedipine and talinolol),
- central nervous system agents (e.g. amitriptyline, buspirone, phenytoin, methadone, midazolam, alprazolam, and sertraline),
- hypoglycaemic agents (e.g. tolbutamide and gliclazide),
- immuno-modulating agents (e.g. cyclosporine and tacrolimus),
- oral contraceptives (birth control pills),
- proton pump inhibitor (e.g. omeprazole),
- respiratory system agent (e.g. theophylline),
- statins (e.g. atorvastatin and pravastatin).
A comprehensive understanding of clinical drugs that interact with SJW has important implications in drug development. New drugs may be designed to minimize interactions with SJW; and new SJW formulations may be designed to avoid drug interactions. Further clinical and mechanistic studies are warranted to explore the interaction of SJW with other important drugs and the potential clinical impact.
Abstract
