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Use of St. John's Wort in potentially dangerous combinations
Scott A Davis1, Steven R Feldman, Sarah L Taylor
11 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine , Winston-Salem, NC.
Objectives:
The objective of this study was to assess how often St. John's wort (SJW) is prescribed with medications that may interact dangerously with it.
Design:
The study design was a retrospective analysis of nationally representative data from the National Ambulatory Medical Care Survey.
Settings:
The study setting was U.S. nonfederal outpatient physician offices.
Subjects:
Those prescribed SJW between 1993 and 2010 were the subjects.
Outcome Measures:
The outcome measures were medications co-prescribed with SJW.
Results:
Twenty-eight percent (28%) of SJW visits involved a drug that has potentially dangerous interaction with SJW. These included selective serotonin reuptake inhibitors, benzodiazepines, warfarin, statins, verapamil, digoxin, and oral contraceptives.
Conclusions:
SJW is frequently used in potentially dangerous combinations. Physicians should be aware of these common interactions and warn patients appropriately.