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Related Experiment Videos

Hyperforin in St. John's wort drug interactions.

Rajanikanth Madabushi1, Bruno Frank, Bernd Drewelow

  • 1Department of Pharmaceutics, College of Pharmacy, University of Florida, P.O. 100494, Gainesville, 32610, USA.

European Journal of Clinical Pharmacology
|February 16, 2006
PubMed
Summary

St. John's wort (SJW) significantly interacts with many prescription drugs by inducing liver enzymes like CYP3A4. The hyperforin content in SJW products directly correlates with the severity of these drug interactions.

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Area of Science:

  • Pharmacology
  • Herbal Medicine
  • Drug Interactions

Background:

  • Interactions between herbal medicines and synthetic drugs are of increasing interest.
  • Over 50 papers in the last 3 years focus on St. John's wort (SJW) interactions with prescription drugs.
  • SJW co-medication decreases plasma concentrations of various drugs, including warfarin, digoxin, and oral contraceptives.

Purpose of the Study:

  • To critically evaluate clinically significant SJW interactions.
  • To assess the role of hyperforin in SJW's drug interactions and antidepressant effects.

Main Methods:

  • Review of clinical studies and case reports on SJW interactions.
  • Analysis of the correlation between hyperforin content and enzyme induction by SJW.
  • Evaluation of SJW's efficacy in depression treatment based on hyperforin levels.

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Main Results:

  • SJW is a potent inducer of cytochrome P450 enzymes (CYP3A4) and P-glycoprotein.
  • Hyperforin levels in SJW products strongly correlate with the degree of enzyme induction.
  • SJW preparations with low hyperforin (<1%) show efficacy in treating mild to moderate depression.

Conclusions:

  • Hyperforin is a key factor in SJW's drug interactions.
  • Low-hyperforin SJW preparations are effective for depression with reduced interaction risk.
  • Clinical significance of SJW interactions is critically dependent on hyperforin content.