St. John’s Wort (Hypericum Perforatum) is a plant cultivated in Europe, North and South America, Australia, New Zealand, and Eastern Asia, with yellow, star-shaped flowers and five petals. In sunny, well-drained areas, the plant grows. It can grow to a height of 50-100 cm.
St. John’s wort also called Hypericum Perforatum may cause some medications to have severe interactions. As a result, France has forbidden the use of St. John’s wort in goods. In other countries, St. John’s Wort can only be obtained when prescription.
The most prevalent use of St. John’s wort is for “blues” or depression and symptoms that often go along with moods, such as nervousness, exhaustion, decreased appetite, and sleeping issues. There is some satisfactory science proof that mild to moderate depression is successful.
St. John’s wort is also used for menopausal symptoms and many other disorders, but no clear clinical evidence is sufficient to support these uses.
It is possible to make oil from St. John’s Wort (Hypericum Perforatum). To treat wounds, some individuals apply this oil to their skin. It may be dangerous to apply St. John’s Wort directly to the skin. Severe exposure to sunlight can be induced.
How does St. John’s Wort (Hypericum Perforatum) work
For a long period, scientists believed that a chemical called hypericin was responsible for its effects on mood change in St. John’s Wort (Hypericum Perforatum). More recent information indicates that other chemicals may play a larger role, such as hyperforin. These chemicals function on mood-regulating messengers in the nervous system.
Uses & Effectiveness
Efficient possibly for
Depression. Taking extracts of St. John’s Wort (Hypericum Perforatum) by mouth increases mood and reduces depression-related nervousness and fatigue. Like many prescription drugs, it seems to be just as successful. The recommendations of the American College of Physicians-American Society of Internal Medicine recommend that St. John’s Wort (Hypericum Perforatum) may be considered an alternative for short-term treatment of moderate depression along with prescription drugs. However, since many drug reactions are caused bySt. John’s Wort (Hypericum Perforatum), the recommendations show that it might not be a good choice for many. St. John’s wort may not be as effective for more severe cases of depression.
- Perhaps Successful for
- Menopause signs. Most studies suggest that it can help to alleviate hot sweats and other menopause symptoms by taking St. John’s wort by mouth. Some evidence suggests that some St. John’s wort + black cohosh (Remifemin; Remifemin +; Gynoplus) combinations may also boost certain menopause symptoms, such as hot flashes and changes in mood. But not all combination products of St. John’s wort tend to be helpful.
- Serious emphasis on a physical symptom (somatic symptom disorder) induces mental distress. Treatment daily for six weeks with a particular St. John’s wort (LI 160, Lichtwer Pharma) product tends to minimize symptoms of somatization disorder.
- Healing Wound. After a Cesarean section (C-section), applying an ointment containing St. John’s wort three times daily for 16 days appears to promote wound healing and decrease scar formation.
DOSAGE
When taken by mouth: When taken by mouth for up to 12 weeks, St. John’s Wort (Hypericum Perforatum) is LIKELY Healthy. Some research also suggests that it can be safely used for more than one year. Some side effects can be triggered, such as difficulty sleeping, vivid dreams, difficulty sitting still, nervousness, irritability, disturbed stomach, nausea, dry mouth, dizziness, headache, rash, diarrhoea, and tingling skin. Take St. John’s in the morning, or if it appears to be causing sleep issues, take a lower dose.
When taken by mouth in large doses, St. John’s Wort (Hypericum Perforatum) is Likely Unhealthy. It could cause serious skin reactions to sun exposure when taken by mouth in large doses. Even with the normal doses of St. John’s wort, women may be at risk of serious skin reactions. Outside, wear sunblock, especially if you are light-skinned.
For many substances, St. John’s Wort (Hypericum Perforatum) interacts. If you want to take St. John’s Wort, let your healthcare provider know. In order to see if there may be any concerns, the healthcare provider may want to check the medications.
When applied to the skin: When it is applied to the skin, there is not enough reliable information available to know whether St. John’s wort is healthy. St. John’s wort can cause sun exposure to severe skin reactions.
Warnings & Special Precautions:
Pregnancy and breastfeeding: St. John’s Wort (Hypericum Perforatum), taken by mouth during pregnancy, is Likely Unhealthy. In unborn rats, there is some evidence that it can cause birth defects. In unborn humans, no one knows yet if it has the same effect. There may be colic, sleepiness, and fussiness in breastfeeding infants of mothers who take St. John’s wort. Do not use St. John’s Wort if you are pregnant or breastfeeding until there is more information.
Children: In children aged 6-17 years, St. John’s work is Likely Healthy when taken by mouth for up to 8 weeks.
Alzheimer’s disease: There is concern that in people with Alzheimer’s disease, St. John’s wort could lead to dementia.
Anaesthesia: Anesthesia can lead to serious heart problems during surgery in people who have used St. John’s Wort for six months. At least two weeks before planned surgery, stop using St. John’s wort.
Attention deficit hyperactivity disorder (ADHD): There is some concern that ADHD symptoms could be intensified by St. John’s wort, especially in people taking the ADHD medication methylphenidate. Do not use St. John’s Wort if you are taking methylphenidate until more is known.
Bipolar disorder: the period of depression and mania in individuals with bipolar disorder, a state characterized by excessive physical activity and impulsive actions. In these people, St. John’s wort can bring on mania and can also speed up the period between depression and mania.
Depression: St. John’s Wort (Hypericum Perforatum) could bring on mania in people with major depression, a state characterized by excessive physical activity and impulsive behaviour.
Infertility: There are some concerns that St. John’s wort can interfere with conceiving a child. It is advisable not to use St. John’s wort when trying to conceive, especially if you already have known fertility problems.
Schizophrenia: In some individuals with schizophrenia, St. John’s wort can bring on psychosis.
Surgery: St. John’s wort can affect brain serotonin levels and interfere with surgical procedures as a consequence. Avoid using St. John’s Wort at least two weeks before your surgery is scheduled.
St. John’s Wort (Hypericum Perforatum) Interactions
Major Interaction
Do not take this combination.
- St. John’s Wort (Hypericum Perforatum) interacts with Alprazolam (Xanax)
For anxiety, alprazolam (Xanax) is widely used. The body breaks down to get rid of alprazolam (Xanax). How easily the body gets rid of alprazolam (Xanax) will raise St. John’s wort. The efficacy of alprazolam (Xanax) may be diminished by taking St. John’s wort, along with alprazolam (Xanax).
- St. John’s Wort (Hypericum Perforatum) interacts with Aminolevulinic acid
You will make your skin sensitive to sunlight with aminolevulinic acid. St. John’s wort can also improve your sunlight sensitivity. The chances of sunburn, blistering or rashes on areas of skin exposed to sunlight can be increased by taking St. John’s wort along with aminolevulinic acid. When spending time in the heat, make sure to wear sunblock and protective clothing.
St. John’s Wort (Hypericum Perforatum) interacts with Amitriptyline (Elavil)
The body breaks down to get rid of amitriptyline (Elavil). St. John’s wort will improve how easily certain drugs get out of the body. St. John’s wort can decrease amitriptyline (Elavil) efficacy by increasing how rapidly amitriptyline (Elavil) is broken down by the body.
Birth control pills (Contraceptive drugs) interact with St. John’s Wort (Hypericum Perforatum)
Estrogen is found in some birth control pills. To get rid of it, the body breaks down the estrogen in birth control pills. The degradation of estrogen could be enhanced by St. John’s wort. Taking St. John’s wort, along with birth control pills, may reduce the efficacy of pills for birth control. Use an extra form of birth control, such as a condom, if you take birth control pills along with St. John’s wort.
Ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), Ethinyl estradiol and levonorgestrel (Triphasil), among others, are several birth control tablets.
Cyclosporine interacts with St. John’s Wort (Hypericum Perforatum) (Neoral, Sandimmune)
Cyclosporine (Neoral, Sandimmune) is broken down by the body to get rid of it. St. John’s wort can increase how easily cyclosporine (Neoral, Sandimmune) breaks down in the body. St. John’s wort could decrease the efficacy of cyclosporine (Neoral, Sandimmune) by raising the breakdown of cyclosporine (Neoral, Sandimmune). If you take cyclosporine (Neoral, Sandimmune), do not take St. John’s Wort.
Digoxin (Lanoxin) interacts with St. John’s Wort (Hypericum Perforatum)
Digoxin (Lanoxin) helps the heart to beat more powerfully in the body. How much digoxin (Lanoxin) the body consumes could be minimized by St. John’s wort. The effects of digoxin (Lanoxin) may be minimized by reducing the amount of digoxin (Lanoxin) consumed by the body by St. John’s wort.
St. John’s Wort (Hypericum Perforatum) combines with Fenfluramine (Pondimin).
A chemical in the brain is improved by fenfluramine (Pondimin). Serotonin is the hormone. Serotonin headache and anxiety are also strengthened by St. John’s wort.
It would seem that taking fenfluramine with St. John’s wort creates too much serotonin. Severe side effects, including heart attacks, shivering, nausea, headache, and anxiety, can be induced.
Imatinib (Gleevec) interacts with St. John’s Wort (Hypericum Perforatum)
Imatinib breaks down in the body to get rid of it. St. John’s wort could increase how easily imatinib (Gleevec) gets out of the body. The efficacy of imatinib (Gleevec) could be diminished by taking St. John’s wort, along with imatinib (Gleevec). If you are using imatinib (Gleevec), do not take St. John’s Wort.
St. John’s Wort (Hypericum Perforatum) interacts with Irinotecan (Camptosar)
To treat cancer, Irinotecan (Camptosar) is used. Irinotecan (Camptosar) is broken down by the body to get rid of it. St. John’s wort can increase the rapid breakdown of irinotecan (Camptosar) by the body and decrease the efficacy of irinotecan (Camptosar).
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with St. John’s Wort (Hypericum Perforatum)
The liver changes some drugs and breaks them down. St. John’s wort can increase how quickly some medications break down in the liver. The potency of such drugs can be decreased by taking St. John’s wort, along with other medicines that are broken down by the liver. If you are taking any drugs that are changed by the liver, talk to the healthcare provider before taking St. John’s wort.
Such liver-changed drugs include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), triazolam (Halcion), fexofenadine (Allegra), and others.
Depression treatments interact with St. John’s Wort (Hypericum Perforatum)
St. John’s Wort stimulates a chemical called serotonin in the brain. Some depression drugs also improve the chemical serotonin in the brain. Taking St. John’s wort can increase serotonin too much along with these depression medications and cause serious side effects, including heart attacks, shivering, and anxiety. If you are taking an antidepressant, do not take St. John’s Wort. Clomipramine (Anafranil), Fluoxetine (Prozac), paroxetine ( Paxil), sertraline ( Zoloft), amitriptyline (Elavil), imipramine (Tofranil), and others are some of these pharmaceutical drugs for depression.
St. John’s Wort (Hypericum Perforatum) interacts with antiretroviral drugs (Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)).
The body breaks down HIV / AIDS drugs. St. John’s wort will improve how easily these drugs are broken down by the body. Taking St. John’s wort can decrease the effectiveness of some Antiretroviral drugs.
Some of these antiretroviral medications include ritonavir (Norvir), amprenavir (Agenerase), saquinavir (Fortovase, Invirase) and nelfinavir (Viracept).
Medications for pain (Narcotic drugs) interacts with St. John’s Wort (Hypericum Perforatum)
The body breaks down some pain drugs in order to get rid of them. St. John’s Wort could reduce how easily the body gets rid of certain pain medications. St. John’s Wort may increase the effects and side effects of some pain medications by reducing how easily the body gets rid of some pain medications.
Some drugs for pain include OxyContin, meperidine (Demerol), morphine, hydrocodone, and many other drugs.
Medications moved by pumps in cells (P-Glycoprotein Substrates) interacts with St. John’s Wort (Hypericum Perforatum)
Pumps in cells are used to transfer certain drugs. St. John’s wort will make these pumps more active and minimize the body’s absorption of certain medications. This could might the efficacy of certain drugs.
Some drugs that are moved by these pumps include ranitidine etoposide, paclitaxel, vinblastine, vincristine, vindesine, quinidine ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, diltiazem, verapamil, cyclosporine corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), loperamide (Imodium), and others.
Medications that increase sensitivity to sunlight (Photosensitizing drugs) interacts with ST. JOHN’S WORT
Medications that improve exposure to sunlight (Photosensitizing drugs) interfere with ST. JOHN ‘S WORT.
Some drugs can increase the sensitivity to sunlight. St. John’s Wort can also increase your sensitivity to sunlight. Taking St. John’s wort along with drugs that increase sensitivity to sunlight can increase the chances of sunburn, blistering, or rash on areas of skin exposed to sunlight. When you spend time in the heat, make sure to wear sunblock and protective clothing.
Some drugs that cause photosensitivity include Ciprofloxacin (Cipro), norfloxacin (Noroxin), trimethoprim/sulfamethoxazole (Septra), lomefloxacin (Maxaquin), ofloxacin (Floxin), levofloxacin (Levaquin), sparfloxacin (Zagam), amitriptyline (Elavil), gatifloxacin (Tequin), moxifloxacin (Avelox), tetracycline, methoxsalen (8-methoxy psoralen, Trioxsalen (Trisoralen) and 8-MOP, Oxsoralen).
ST. JOHN ‘S WORT combines with Meperidine (Demerol)
A chemical in the brain called serotonin is boosted by St. John’s Wort. Serotonin can also be boosted in the brain by meperidine (Demerol). Too much serotonin in the brain and severe side effects, including heart attacks, shivering, and anxiety, may be triggered by taking St. John’s wort along with meperidine (Demerol).
ST. JOHN ‘S WORT interacts with Nefazodone (Serzone)
Nefazodone can increase the brain’s chemical content. Serotonin is called this drug. Serotonin can also be boosted by St. John’s Wort. Taking St. John’s wort with nefazodone could lead to too much serotonin being present. This may result in severe side effects, including shivering, restlessness and problems with the heart.
Nortriptyline interacts with ST. JOHN ‘S WORT (Pamelor)
The body breaks down in order to get rid of nortriptyline (Pamelor). St. John’s wort will improve the rapid breakdown of nortriptyline (Pamelor) by the body. The efficacy of nortriptyline (Pamelor) may be decreased by this.
Paroxetine (Paxil) interacts with the WORT of ST. JOHN
Paroxetine (Paxil) increases the brain’s chemical content. Serotonin is called this drug. St. John’s wort also raises serotonin levels. Taking paroxetine (Paxil) and St. John’s wort together could lead to too much serotonin being present. This may result in severe side effects, including problems with the heart, shivering, and fatigue.
ST. JOHN ‘S WORTT interacts with Pentazocine (Talwin).
A brain chemical called serotonin is improved by St. John’s Wort. Often, pentazocine (Talwin) improves the serotonin. Along with pentazocine (Talwin), taking St. John’s wort could increase serotonin too much. Severe side effects, including heart attacks, shivering and anxiety, may be caused by this… DIt is not advisable to take St. John’s wort when taking pentazocine (Talwin).
St. John’s Wort (Hypericum Perforatum) interacts with Phenobarbital (Luminal)
The body breaks down in order to get rid of the phenobarbital (Luminal). St. John’s wort could increase how easily phenobarbital is broken down by the body. This could limit how well phenobarbital operates.
Phenprocoumon interactes with St. John’s Wort (Hypericum Perforatum)
Phenprocoumon is broken down in the body to get rid of. St. John’s wort increases how easily Phenprocoumon breaks down from the body. This limits the potency of Phenprocoumon.
Phenytoin (Dilantin) interacts with St. John’s Wort (Hypericum Perforatum)
The body breaks down to get rid of phenytoin (Dilantin). St. John’s wort can increase how quickly phenytoin is broken down by the body. Taking St. John’s wort and taking phenytoin (Dilantin) may decrease phenytoin (Dilantin) efficacy and increase the risk of seizures.
Reserpine interacts with St. John’s Wort (Hypericum Perforatum)
St. John’s wort can reduce the effects of reserpine.
Sedative drugs (Barbiturates) interact with St. John’s Wort (Hypericum Perforatum)
Sedatives are called drugs that cause sleepiness and drowsiness. The potency of sedative drugs may be decreased by St. John’s wort. The explanation for this interaction is not clear.
St. John’s Wort (Hypericum Perforatum) interacts with Sertraline (Zoloft)
Sertraline (Zoloft) can increase the brain’s chemical content. Serotonin is called this drug. St. John’s wort also raises serotonin levels. This can cause the brain to have too much serotonin in it. This may result in severe side effects, such as problems with the pulse, shivering, and irritability.
St. John’s Wort (Hypericum Perforatum) interacts with Tacrolimus (Prograf, Protopic)
Tacrolimus (Prograf, Protopic) is broken down by the body to get rid of it. St. John’s wort will boost how easily tacrolimus breaks down in the body. Tacrolimus could be less successful because of this.
St. John’s Wort (Hypericum Perforatum) interacts with Tramadol (Ultram)
A chemical in the brain called serotonin might be affected by Tramadol (Ultram). Serotonin may also be caused by St. John’s Wort. Too much serotonin in the brain can trigger some side effects, including confusion, shivering, stiff muscles and other side effects, can be caused by taking St. John’s wort along with tramadol (Ultram).
Warfarin (Coumadin) interacts with St. John’s Wort (Hypericum Perforatum)
To delay blood clotting, warfarin (Coumadin) is used. The body breaks down to get rid of warfarin ( Coumadin). The breakdown may be improved and the potency of warfarin ( Coumadin) diminished by St. John’s wort. Decreasing the efficacy of warfarin ( Coumadin) might increase the risk of coagulation. Make sure you regularly have your blood tested. It may be appropriate to adjust the dosage of your warfarin ( Coumadin).
Moderate Interaction
Be cautious with this combination!
St. John’s Wort (Hypericum Perforatum) interacts with Clopidogrel (Plavix)
Clopidogrel (Plavix) is broken down into a chemical by the body that reduces blood clotting in the body. Taking clopidogrel (Plavix) and St. John’s wort may increase how well clopidogrel (Plavix) is broken down by the body and minimize too much blood clotting.
St. John’s Wort (Hypericum Perforatum) interacts with Dextromethorphan (Robitussin DM, and others).
A brain chemical called serotonin can be influenced by St. John’s Wort. Serotonin can also be affected by Dextromethorphan (Robitussin DM, others). Too much serotonin in the brain and severe side effects, including heart attacks, shivering, and anxiety, may be caused by taking St. John’s wort with dextromethorphan (Robitussin DM, others). When taking dextromethorphan (Robitussin DM, and others), you should not take St. John’s Wort.
St. John’s Wort (Hypericum Perforatum) combines with Fexofenadine (Allegra)
Fexofenadine (Allegra) breaks down in the body to get rid of it. St. John’s wort could minimize the speed at which the body gets rid of fexofenadine.
Medications broken down by the liver (Cytochrome P450 1A2 (CYP1A2) substrates) interacts with ST. JOHN’S WORT
The liver changes some drugs and breaks them down. St. John’s wort can increase how quickly some medications break down in the liver. The efficacy of such drugs can be decreased by taking St. John’s wort, along with other medicines that are altered by the liver. If you take any drugs that are altered by the liver, speak to the healthcare provider before taking St. John’s wort.
Some of these medications that are broken down by the liver include cyclobenzaprine (Flexeril),zolmitriptan (Zomig), fluvoxamine (Luvox), haloperidol (Haldol), imipramine clozapine (Clozaril), (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), zileuton (Zyflo) and others drugs.
Medications altered by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with St. John’s Wort (Hypericum Perforatum)
The liver changes some drugs and breaks them down. St. John’s wort can increase how quickly some medications break down in the liver. The potency of your drug can be decreased by taking St. John’s wort, along with other drugs that are broken down by the liver. If you take any drugs that are altered by the liver, speak to the healthcare provider before taking St. John’s wort.
Some medicines that are altered by the liver include amitriptyline (Elavil), warfarin (Coumadin), zileuton (Zyflo), celecoxib (Celebrex), diclofenac (Voltaren), tamoxifen (Nolvadex),fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), diazepam (Valium), tolbutamide (Tolinase), torsemide (Demadex), and others.
Medications for depression (MAOIs) interacts with St. John’s Wort (Hypericum Perforatum)
A chemical in the brain raises St. John’s Wort. Serotonin is called this drug. Serotonin is also boosted by certain drugs used for depression. Taking St. John’s wort with these medicines used for depression can cause too much serotonin to be present. Severe side effects, including heart attacks, anxiety and shivering, may be caused by this.
Phenelzine (Nardil), tranylcypromine (Parnate), and others include some of these drugs used for depression.
St. John’s Wort (Hypericum Perforatum) combines with drugs for migraine headaches (‘Triptans’)
A chemical called serotonin in the brain may affect certain drugs for migraine headaches. Serotonin may also be caused by St. John’s Wort. Too much serotonin in the brain and severe side effects like confusion, shivering, tense muscles, and other side effects may be induced by taking St. John’s wort along with other migraine headache drugs.
Frovatriptan (Frova), naratriptan (Amerge), rizatriptan are some of the drugs for migraine headaches.
Some medications for migraine headache include zolmitriptan (Zomig), sumatriptan (Imitrex), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt).
St. John’s Wort (Hypericum Perforatum) interacts with Procainamide
The extract of St. John’s wort could improve how much Procainamide the body absorbs. The effects and side effects of Procainamide may be improved by this. But there is no awareness of the importance of this possible relationship.
Simvastatin (Zocor) interacts with St. John’s Wort (Hypericum Perforatum)
The body breaks down to get rid of simvastatin (Zocor). St. John’s Wort improves how easily simvastatin breaks down in the body. Simvastatin could be less effective because of this.
Minor Interaction
Be mindful of this combination!
Methylphenidate (Concerta, Daytrana, Metadate, Ritalin) interacts with St. John’s Wort (Hypericum Perforatum)
Taking methylphenidate with St. John’s wort, can reduce how well methylphenidate works for treating symptoms of attention deficit-hyperactivity disorder (ADHD).
Theophylline interacts with St. John’s Wort (Hypericum Perforatum)
To get rid of it, the body breaks down theophylline. St. John’s wort will improve how easily the theophylline gets out of the body. The potency of theophylline may be decreased by taking St. John’s wort, along with theophylline. But if this interaction is a major problem, it is not obvious.
Dosing
The following doses have been researched;
ADULTS
- ORALLY
St. John’s Wort (Hypericum Perforatum) extract has been standardized to 0.3 per cent hypericin content in most studies and used three times daily at doses of 300 mg.
Some studies have used a 0.2 per cent hypericin standardized extract of St. John’s wort at doses of 250 mg twice daily. The 5 per cent hyperforin standardized extract of St. John’s wort can be used three times daily at doses of 300 mg.
For menopausal symptoms:
The extract of St. John’s wort (Hypiran, Poursina Pharmaceutical Mfg. Co., Tehran, Iran) containing 0.2 mg / mL of hypericin was used three times daily in doses of 20 drops for two months.
300 mg of St. John’s wort was used three times daily for 3-4 months.
A particular extract (LI 160, Lichtwer Pharma) has been used for mental distress triggered by an intense emphasis on a physical symptom (somatic symptom disorder): 600 mg/day.
TO THE SKIN APPLIED:
For wound healing: An ointment containing a 5 per cent extract of St. John’s wort was applied three times a day starting 24 hours after a C-section and continued for 16 days.
CHILDREN
ORALLY:
Or mild to moderate depression: 150-300 mg of St. John’s wort was used in children aged 6-17 years three times daily for eight weeks. A particular extract of St. John’s wort (LI 160, Lichtwer, Pharma) 300-1800 mg was used in three divided daily doses for up to 6 weeks.
Don’t stop taking St. John’s Wort all of a sudden. This may cause side effects which are unpleasant. Slowly decrease the dosage over time if you plan to avoid taking St. John’s wort.
