Drug Interactions of St. John’s Wort Herb

Safely Using St. John’s Wort

St. John’s Wort is a popular herbal remedy for anxiety and depression. It is taken internally as a tea, tincture, or in pill form. Herbalists use it for many ailments as it has many healing benefits. St. John’s Wort (Hypericum perforatum), also known as Klamathweed in some parts of the world, is actually used externally as well. Externally, the infused oil from the flower is used to heal nerve pain as well as muscle aches and pain. The oil is also used to ease the pain of Fibromyalgia.

While St. John’s Wort is an effective herb for both depression and anxiety, it does tend to interact with a large number of Western medications. In most cases, St. John’s wort decreases the effectiveness of the medication which can cause serious health issues. In other cases however, St. John’s wort may increase the effects of a medication which can lead to severe issues, or possibly death.

The contraindications of St. John’s Wort makes it very important for you to know what you can and can not take if you plan on taking the herb.

If you are taking any of the following medications, you should not use St. John’s Wort. While it is a comprehensive list, there may have been some medications not mentioned. It is best to talk to your doctor, or health care provider.

Antidepressants

If you are presently taking antidepressants, St. John’s Wort may possibly interact with the medications that you are already taking for your depression or other mood disorders. Taking St. Johns with these medications increase side effects and can lead to a very dangerous condition called serotonin syndrome.

The medications would include:

Tricyclic antidepressants. These would include Amitriptyline (Elavil), nortryptyline (Pamelor), or imipramine (Tofranil)

SSRIs, and monoamine oxidase inhibitors (MAOIs). This includes medications like Phenelzine, (Nardil), or tranylcypromine (Parnate)

Citalopram (Celexa)

escitalopram (Lexapro)

fluvoxamine (Luvox)paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft)

Anxiety and Sedative Drugs

If you are taking other sedative medications, for either anxiety or stress, St. John’s wort may increase the effect of drugs that have a sedating effect.

Medications such as barbiturates, Benzodiazepines such as alprazolam (Xanax) and diazepam (Valium) should not be used in conjunction with St. John’s Wort. Drugs to treat insomnia such as zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta), and ramelteon (Rozerem) should also not be used while taking St. John’s wort.

St. John’s Wort increases the effect of the medication, and an overdose can occur.

Antihistamines

If you take medication for allergies, and take antihistamines, St. John’s wort may reduce levels of these drugs in the body, making them less effective. It is important not to take antihistamines with St. John’s Wort herb.

Those antihistamines include:

Loratadine (Claritin)

Cetirizine (Zyrtec)

Fexofenadine (Allegra)

Birth Control

Stay clear of St. John’s Wort if you taking any form of birth control. There have been reports of women having breakthrough bleeding while using the herb. It may be possible that the herb interferes with the effectiveness of the birth control pills, leading to unwanted or unplanned pregnancies.

Immuno Suppressing Medications

St. John’s wort can reduces the effectiveness of immuno suppressing medications. When these medicines are taken after an organ transplant or to control autoimmune diseases, it is important not to interfere with the drugs effectiveness. There have been reports of certain blood levels dropping, and the transplanted organ is rejected by the body.

The popular immuno suppressant drugs are below, but others could be prescribed.

Adalimumab (Humira),Azathioprine (Imuran),Cyclosporine, Etanercept (Enbrel), and Tacrolimus (Prograf)

Heart Medication

Digoxin, which is taken as a heart medication, is not to be taken with St. John’s wort. St. John’s wort may decrease levels of the medication and reduce its effectiveness. This would also go for other medications taken to control heart issues.

High Blood Pressure Drugs

Animal studies have shown that St. John’s Wort can interfere with the high blood pressure medications such as Reserpine. The herb can cause a decrease in the way the body uses these medications, and can cause health issues, and other unwanted side effects. Stay clear of St. John’s if you taking medicine for high blood pressure.

HIV Antiretroviral Medications

St. John’s Wort herb seems to interact with at least two kinds of medications that are used to treat HIV and AIDS patients. Drugs that are used to fight HIV, and AIDS are called protease inhibitors and non-nucleoside reverse transcriptase inhibitors. When HIV infects a CD4 cell in the body, it copies its own genetic code into the cell’s DNA. The cell is then creates new copies of HIV virus. NNRTIs, also known as “non-nucleosides” or “non-nukes” for short, attach themselves to reverse the process and prevent the enzyme from converting RNA to DNA. This prevents the HIV virus genetic code from getting into the healthy genetic material of the cell. This helps stop the cell from producing new virus. These drugs help to keep the immune system in balance, and it is best not to use St. John’s Wort with any antiretroviral medications.

Anticonvulsant Medications

If you are taking anticonvulsant medications such as phenytoin (Dilantin) and valproic acid (Depakote) for seizures, it is best to stay clear of the herb St. John’s Wort.

The herb interacts and can make the medicine less effective causing harmful health issues.

Asthma and Other COPD Drugs

For those who suffer from asthma, emphysema, chronic bronchitis or other COPD disorder, and are taking theophylline, you should not take St. John’s Wort.

The herb can reduce levels of this medication in the blood causing severe health issues.

Migraine Medications

Medications to treat migraines called Triptans, should not be taken if using St. John’s wort. The herb can increase the risk of the side effects of the medication, including serotonin syndrome.

Migraine medications include:

Naratriptan (Amerge)

Rizatriptan (Maxalt)

Sumatriptan (Imitrex)

Zolmitriptan (Zomig)

Blood Thinning Medications

If you are taking blood thinning medications such as Warfarin, which is an anticoagulant drug, St. John’s wort reduces the effectiveness of them.

By taking both the herb and the drug, this would increase the chance of sudden heart attack or stroke, or death.

Antifungal Medications

St. John’s wort is broken down by certain liver enzymes. Due to this fact, it may interact with other drugs that are broken down by the same liver enzymes. Those drugs may include:

Drugs that are used as antifungal medications such as ketoconazole (Nizoral), itraconazole (Sporanox), fluconazole (Diflucan)

Statins and Blood Pressure Drugs

Statins, a famous drug that is used to lower cholesterol is also broken down by the liver. Other medications that are broken down by the liver are calcium channel blockers, which is used to lower blood pressure.

Other St. John’s Wort Interactions

Alcohol of any kind acts as antidepressant in the body. It should not be consumed if you are taking or using St. John’s Wort.

St. John’s Wort Oil

St. John’s Wort Oil is used to treat nerve pain such as sciatica. It can also be used to treat pain from Fibromyalgia. The oil makes a great massage oil for body aches from overexertion or exercise.

Work With Your Doctor

If you are taking any medications, including to but not limited to the ones that are listed here, it is best to talk to your health care provider before taking St. John’s Wort. Many doctors don’t understand herbs and all their components, so finding a herbalist, or someone well versed in herbs may be helpful in your health care decisions.

Whether you choose to use St. John’s Wort internally for anxiety and depression, or externally for aches and pains, the side effects would be the same. Remember, the skin is our largest organ, and if you are applying St. John’s Wort Oil to you skin, it is being absorbed into your body.

For More Information on St. John’s Wort http://www.cloverleaffarmherbs.com/st-johns-wort/