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Table of Contents > Herbs > St. John's Wort > Interactions
Possible Interactions with: St. John's Wort
Also listed as: Hypericum perforatum; Klamathweed
 

St. John's wort interacts with a range of medications. In most cases, this interactions leads to reduced the effectiveness of the medication in question; in other cases, however, St. John's wort may increase the effects of a medication.

If you are currently being treated with any of the following medications, you should not use St. John's wort without first talking to your healthcare provider:

Antidepressants
St. John's wort may interact with antidepressant medications that are used to treat depression or other mood disorders, including tricyclics, SSRIs (see earlier discussion), and monoamine oxidase inhibitors (MAOIs) such as phenelzine. How St. John's wort works is not entirely clear, but is believed to be similar to how SSRIs work. Therefore, using St. John's wort with this class of antidepressants in particular can lead to exacerbation of side effects including headache, dizziness, nausea, agitation, anxiety, lethargy, and lack of coherence.

Digoxin
St. John's wort should not be taken by those on digoxin because the herb may decrease levels of the medication and reduce its effectiveness.

Immunosuppressive medications
St. John's wort should not be taken by those on immunosuppressive medications such as cyclosporine because it may reduce the effectiveness of these medications. In fact, there have been many reports of cyclosporin blood levels dropping in those with a heart or kidney transplant, even leading to rejection of the transplanted organ.

Indinavir and other protease inhibitors
The Food and Drug Administration (FDA) issued a public health advisory in February 2000 concerning the probable interaction between indinavir and St. John's wort that resulted in significantly decreased blood levels of this protease inhibitor, a class of medications used to treat HIV or AIDS. The FDA recommends that St. John's wort not be used with any type of antiretroviral medication used to treat HIV or AIDS.

Loperamide
There has been a report of a possible interaction between St. John's wort and the antidiarrheal medication, loperamide leading to delirium in an otherwise healthy woman.

Oral contraceptives
There have been reports of breakthough bleeding in women on birth control pills who were also taking St. John's wort.

Reserpine
Based on animal studies, St. John's wort may interfere with the intended action of this medication used to treat high blood pressure.

Theophylline
St. John's wort can reduce levels of this medication in the blood leading. Theophylline is used to open the airways in those suffering from asthma, emphysema, or chronic bronchitis.

Warfarin
St. John's wort interferes with the anticoagulant medication, warfarin, by reducing blood levels as well as the effectiveness. This leads to the need to for adjustments in doses of this medication.


Drug Interactions
Antidepressant Medications
Birth Control Medications
Cyclosporine
Digoxin
Immunosuppressive Medications
Protease Inhibitors
Theophylline-containing Medications
Warfarin

Copyright © 2004 A.D.A.M., Inc

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

 
RELATED INFORMATION
St. John's Wort
  Uses of this Herb
Alcoholism
Burns
Depression
Encephalitis, Viral
Hemorrhoids
HIV and AIDS
Otitis Media
Premenstrual Syndrome
Wounds
  Herbs with Similar Uses
View List by Use
  Drugs that Interact
Summary
Antidepressant Medications
Birth Control Medications
Cyclosporine
Digoxin
Immunosuppressive Medications
Protease Inhibitors
Theophylline-containing Medications
Warfarin
  Herbs with Similar Side Effects
View List by Side Effect
  Herbs with Similar Warnings
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