Quote from Forum Archives on August 29, 2003, 9:08 am

Posted by: rxdca <rxdca@...>

At 05:54 AM 8/29/2003 -0700, you wrote:
>Brothers & Sisters,
>All your prayers and concerns for my wife were very
>encouraging and helpful. She is now on Zoloft, Saint
>Johns Wart

Oops... St. Johns Wort induces the metabolism of many medications and could
decrease their effectiveness... including Zoloft. The two really shouldn't
be used together. See below:

Authors:
Henderson, L. 1; Yue, Q. Y. 2; Bergquist, C. 2; Gerden, B. 2; Arlett, P. 1

Institution
(1)Pharmacovigilance Group, Medicines Control Agency, UK
(2)Medical Products Agency, Sweden

Title
St John's wort (Hypericum perforatum): drug interactions and clinical
outcomes.[Review]

Source
British Journal of Clinical Pharmacology. 54(4):349-356, October 2002.

Abstract
Aims: The aim of this work is to identify the medicines which interact with
the herbal remedy St John's wort (SJW), and the mechanisms responsible.

Methods: A systematic review of all the available evidence, including
worldwide published literature and spontaneous case reports provided by
healthcare professionals and regulatory authorities within Europe has been
undertaken.

Results: A number of clinically significant interactions have been
identified with prescribed medicines including warfarin, phenprocoumon,
cyclosporin, HIV protease inhibitors, theophylline, digoxin and oral
contraceptives resulting in a decrease in concentration or effect of the
medicines. These interactions are probably due to the induction of
cytochrome P450 isoenzymes CYP3A4, CYP2C9, CYP1A2 and the transport protein
P-glycoprotein by constituent(s) in SJW. The degree of induction is
unpredictable due to factors such as the variable quality and quantity of
constituent(s) in SJW preparations. In addition, possible pharmacodynamic
interactions with selective serotonin re-uptake inhibitors and serotonin
(5-HT1d) receptor-agonists such as triptans used to treat migraine were
identified. These interactions are associated with an increased risk of
adverse reactions.

Conclusions: In Sweden and the UK the potential risks to patients were
judged to be significant and therefore information about the interactions
was provided to health care professionals and patients. The product
information of the licensed medicines involved has been amended to reflect
these newly identified interactions and SJW preparations have been
voluntarily labelled with appropriate warnings.

Douglas
rxdca@usa.net

Phil 4:13

"We will not tire, we will not falter, and we will not fail."
- George W. Bush, Sept. 20, 2001