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Br J Clin Pharmacol 2018 12 11;84(12):2903-2913. Epub 2018 Oct 11.

Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.

Aims: We assessed the potential mutual interaction of oral macitentan (cytochrome P450 (CYP) 3A4 substrate) at steady-state with single-dose oral rivaroxaban (CYP3A4 and P-glycoprotein substrate) and evaluated the effect of the CYP3A and P-glycoprotein inducer St John's wort (SJW) on the pharmacokinetics of these drugs in healthy volunteers.

Methods: Twelve healthy volunteers completed this open-label, monocentre, two-period, one-sequence phase I clinical trial. The pharmacokinetics of macitentan (10 mg) was assessed on study days 3 (single dose), 15 (steady-state), 16 (impact of rivaroxaban) and 29 (after induction by oral SJW), and of rivaroxaban on days 2 (single dose), 16 (impact of macitentan at steady-state) and 29 (after induction by SJW). Read More

Expert Opin Drug Metab Toxicol 2017 Oct 13;13(10):1047-1062. Epub 2017 Sep 13.

d Toxicology and Diseases Group, Pharmaceutical Sciences Research Center , Tehran University of Medical Sciences , Tehran , Iran.

Introduction: St. John's wort (SJW) is a common medicinal herb used for the treatment of mild to moderate depression. Hyperforin, one of the chief components of SJW, plays an important role in the induction of cytochrome P450 enzymes (CYP) and P-glycoprotein transporter (P-gp), and therefore, affects the pharmacokinetics of various drugs. Read More

J Pharm Pharmacol 2019 Jan 27;71(1):117-128. Epub 2017 Jun 27.

Department of General Practice, The University of Melbourne, Carlton, Vic., Australia.

Background: Extracts of Hypericum perforatum, more commonly known as St John's wort (SJW), have good evidence for treating depression. The herb is easily accessible and widely used by consumers, although it has potential for interaction with other medicines. Consumers' use of SJW is often not discussed with their general practitioners (GPs). Read More

Expert Opin Drug Metab Toxicol 2014 Mar 6;10(3):359-77. Epub 2014 Jan 6.

University Hospital of Heidelberg, Department Clinical Pharmacology and Pharmacoepidemiology , Im Neuenheimer Feld 410, 69120 Heidelberg , Germany +49 6221 56 8740 ; +49 6221 56 4642 ;

Introduction: Because 30 to 70% of tumour patients use complementary and alternative medicines; herb-drug combinations are particularly frequent in this population. Some of these combinations can critically alter exposure of anti-neoplastic and palliative treatment.

Areas Covered: This review summarises pharmacokinetic drug interactions caused by the herbal products most frequently used by tumour patients (garlic, ginkgo, ginseng, echinacea and St John's wort [SJW]). Read More

Med Decis Making 2014 01 19;34(1):97-106. Epub 2013 Jun 19.

Edward Hines VA Medical Center, Hines, IL (BK, FMW)

Background And Objective: . Adapting best evidence to the care of the individual patient has been characterized as "contextualizing care" or "patient-centered decision making" (PCDM). PCDM incorporates clinically relevant, patient-specific circumstances and behaviors, that is, the patient's context, into formulating a contextually appropriate plan of care. Read More

J Affect Disord 2008 Apr 17;107(1-3):205-10. Epub 2007 Aug 17.

Research Group Psychosomatic Rehabilitation at the Charité University Medicine Berlin, Germany.

Background: Depressive disorders are frequent. They are frequently unrecognised or sufferers use self help or self medication, e.g. Read More

Holist Nurs Pract 2006 Jul-Aug;20(4):197-203

Central Utah Medical Clinic, Provo, UT 84602, USA.

A systematic review of randomized controlled trials was conducted to determine the efficacy of St. John's Wort (SJW) in the treatment of mild to moderate depression. The Boyak and Lookinland Methodological Quality Index was used to evaluate the studies. Read More

J Fam Pract 1999 Aug;48(8):615-9

Department of Family Medicine, Medical College of Georgia, Augusta 30912-3500, USA.

Background: The number of visits to alternative medicine practitioners in this country is estimated at 425 million, which is more than the number of visits to allopathic primary care physicians in 1990. Patients' use of St. John's Wort (SJW) has followed this sweeping trend. Read More