Hyperforin in St. John’s wort drug interactions

@article{Madabushi2006HyperforinIS,
  title={Hyperforin in St. John’s wort drug interactions},
  author={R. Madabushi and B. Frank and B. Drewelow and H. Derendorf and V. Butterweck},
  journal={European Journal of Clinical Pharmacology},
  year={2006},
  volume={62},
  pages={225-233}
}
Recently, interactions of herbal medicines with synthetic drugs came into focus of particular interest. In the past 3 years, more than 50 papers were published regarding interactions between St. John’s wort (Hypericum perforatum L.; SJW) and prescription drugs. Co-medication with SJW resulted in decreased plasma concentrations of a number of drugs including amitriptyline, cyclosporine, digoxin, indinavir, irinotecan, warfarin, phenprocoumon, alprazolam, dextrometorphane, simvastatin, and oral… Expand
Clinical relevance of St. John's wort drug interactions revisited
TLDR
This review revisits the current knowledge of the mechanisms of action and on how pharmacokinetic drug interactions with SJW could be avoided and the degree of CYP3A4 induction correlates significantly with the hyperforin content in the preparation. Expand
No Clinically Relevant Interactions of St. John's Wort Extract Ze 117 Low in Hyperforin With Cytochrome P450 Enzymes and P‐glycoprotein
TLDR
Ze 117 does not show clinically relevant pharmacokinetic interactions with important CYPs and P‐glycoprotein, and is well within the predefined bioequivalence range of 80–125%. Expand
Drug Interactions with Herbal Medicines
TLDR
The present article summarizes herbal medicine-drug interactions involving mainly inhibition or induction of cytochrome P450 enzymes and/or drug transporters and describes the clinical implications of these interactions. Expand
Drug–Herb and Drug–Food Interactions
TLDR
Consumption of a single glass of grapefruit juice caused a twofold to threefold increase in the plasma concentration of felodipine, and pharmocokinetics of approximately 40 other drugs are also affected by intake of Grapefruit juice, and bioavailability of fexofinadine was significantly reduced by grapefruit Juice. Expand
No clinically relevant CYP3A induction after St. John’s wort with low hyperforin content in healthy volunteers
TLDR
Administration of an SJW product with low hyperforin content resulted in a mild induction of CYP3A not considered clinically relevant. Expand
Evaluation of metabolism-mediated herb-drug interactions
TLDR
Major factors affecting the metabolism of herbal medicines, mechanisms of herb- drug interactions mediated by CYPs and UGTs, and several in vitro methods to assess the herb-drug interactions are described. Expand
Kritische Bewertung und klinische Relevanz
Pharmacokinetic herb-drug interactions are caused by an induction or inhibition of cytochrome P450 (CYP) enzymes or transporters e.g. P-glycoprotein. St. John’s wort extracts containing hyperforinExpand
Hyperforin and its analogues inhibit CYP3A4 enzyme activity.
TLDR
As the acylphloroglucinols are potent inhibitors of the CYP3A4 enzyme, their modulation of the enzyme activity is unlikely to be involved in increased drug metabolism by St. John's wort. Expand
Interactions Between Herbal Medicines and Prescribed Drugs
TLDR
Numerous interactions between herbal medicines and conventional drugs have been documented, while the significance of many interactions is uncertain, several interactions, particularly those with St John’s wort, may have serious clinical consequences. Expand
Interaction of St John's wort (Hypericum perforatum) with clozapine.
TLDR
The reduced plasma clozapine level and the psychiatric condition normalized after the withdrawal of St John's wort, and Physicians should be alert to patients self-medicating with over-the-counter medicines, especially when these medicines can lower clozAPine concentrations below the therapeutic range. Expand
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