Influence of St. Johnâs wort on the steadystate pharmacokinetics and metabolism of bosentan

Markert, Christoph; Ngui, Prisca; Hellwig, Regina; Wirsching, Theresia; Kästner, I; Riedel, K.; Burhenne, Jürgen; Weiß, Johanna; Mikus, Gerd; Haefeli, Walter E.

doi:10.5414/cp202048

Cited by 14 publications

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“…Therefore, several controlled clinical studies have been issued proving that SJW significantly modifies the pharmacokinetics of drugs that are substrate of CYP3A, 2C9, 2C19, 2E1 or transported by P-gp or both, including midazolam [ 33 ], simvastatin [ 36 ], amitriptyline [ 37 ], chlorzoxazone [ 38 , 39 ], methadone [ 40 ], ethinyl estradiol/norethindrone combination oral contraceptives [ 41 , 42 ], fexofenadine [ 43 ], warfarin [ 44 ], imatinib [ 45 ], omeprazole [ 46 ], mephenitoin [ 47 ], tacrolimus [ 48 ], verapamil [ 49 ], voriconazole [ 50 ], talinolol [ 51 ], gliclazide [ 52 ], nifedipine [ 53 ], ketamine [ 54 ], zolpidem [ 55 ], bosentan [ 56 ], ambrisentan [ 57 ] and docetaxel [ 58 ] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…In fact, some data show that a treatment period of 14-days with SJW [33,34] is needed to produce significant effect on CYP3A4 activity while a short-term one doesn't induce any effect [33,35]. Therefore, several controlled clinical studies have been issued proving that SJW significantly modifies the pharmacokinetics of drugs that are substrate of CYP3A, 2C9, 2C19, 2E1 or transported by P-gp or both, including midazolam [33], simvastatin [36], amitriptyline [37], chlorzoxazone [38,39], methadone [40], ethinyl estradiol/norethindrone combination oral contraceptives [41,42], fexofenadine [43], warfarin [44], imatinib [45], omeprazole [46], mephenitoin [47], tacrolimus [48], verapamil [49], voriconazole [50], talinolol [51], gliclazide [52], nifedipine [53], ketamine [54], zolpidem [55], bosentan [56], ambrisentan [57] and docetaxel [58] (Table 1). Intriguingly, SJW interaction was expanded to multidrug resistance ATP-binding cassette (ABC) proteins and solute carrier (SLC) transporters as reported initially in a case report [59].…”

Section: St John's Wort (Sjw)mentioning

confidence: 99%

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Pharmacokinetic Interactions between Herbal Medicines and Drugs: Their Mechanisms and Clinical Relevance

Rombolà

Scuteri

Straface

et al. 2020

Life

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The therapeutic efficacy of a drug or its unexpected unwanted side effects may depend on the concurrent use of a medicinal plant. In particular, constituents in the medicinal plant extracts may influence drug bioavailability, metabolism and half-life, leading to drug toxicity or failure to obtain a therapeutic response. This narrative review focuses on clinical studies improving knowledge on the ability of selected herbal medicines to influence the pharmacokinetics of co-administered drugs. Moreover, in vitro studies are useful to anticipate potential herbal medicine-drug interactions. In particular, they help to elucidate the cellular target (metabolic or transporter protein) and the mechanism (induction or inhibition) by which a single constituent of the herbal medicine acts. The authors highlight the difficulties in predicting herbal–drug interactions from in vitro data where high concentrations of extracts or their constituents are used and pharmacokinetics are missed. Moreover, the difficulty to compare results from human studies where different kinds of herbal extracts are used is discussed. The herbal medicines discussed are among the best sellers and they are reported in the “Herbal Medicines for Human Use” section of the European Medicinal Agency (EMA).

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Section: Resultsmentioning

confidence: 99%

Section: St John's Wort (Sjw)mentioning

confidence: 99%

Pharmacokinetic Interactions between Herbal Medicines and Drugs: Their Mechanisms and Clinical Relevance

Rombolà

Scuteri

Straface

et al. 2020

Life

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“…Search term ‘Hypericum’ resulted in 2500 references, of which 807 were published after 31 December 2009. Overall, this resulted in a total of 59 pharmacokinetic interaction studies (Table ) of which 12 were identified since 2010 . Each study investigated interactions with Hypericum products reported to have a high‐hyperforin content.…”

Section: Resultsmentioning

confidence: 99%

Understanding drug interactions with St John's wort (Hypericum perforatumL.): impact of hyperforin content

Chrubasik‐Hausmann

Vlachojannis

McLachlan

2018

Journal of Pharmacy and Pharmacology

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Objective The aim of this study was to review herb-drug interaction studies with St John's wort (Hypericum perforatum L.) with a focus on the hyperforin content of the extracts used in these studies. Methods PUBMED was systematically searched to identify studies describing pharmacokinetic interactions involving St John's wort. Data on study design and the St John's wort extract or product were gathered to extract hyperforin content and daily dose used in interaction studies. Key findings This analysis demonstrates that significant herb-drug interactions (resulting in a substantial change in systemic exposure) with St John's wort products were associated with hyperforin daily dosage. Products that had a daily dose of <1 mg hyperforin were less likely to be associated with major interaction for drugs that were CYP3A4 or p-glycoprotein substrates. Although a risk of interactions cannot be excluded even for low-dose hyperforin St. John's wort extracts, the use of products that result in a dose of not more than 1 mg hyperforin per day is recommended to minimise the risk of interactions. Conclusions This review highlights that the significance of herb-drug interactions with St John's wort is influenced by the nature of the herbal medicines product, particularly the hyperforin content.

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“…There are numerous intrinsic and extrinsic factors that can alter medication effectiveness and/or side effects among individuals. These include, but are not limited to, drug solubility [ 51 ], intestinal pH [ 51 ], drug interactions [ 52 ], age [ 53 ], sex [ 53 , 54 ], weight [ 53 ], diet [ 55 , 56 ], genetics [ 57 ], circadian rhythms [ 58 ], supplement use [ 59 ], health of the individual [ 60 ], developed tolerance [ 61 ], dosage [ 62 ], route of administration [ 62 ], etc.…”

Section: Discussionmentioning

confidence: 99%

Medication use and the risk of motor vehicle collision in West Virginia drivers 65 years of age and older: a case-crossover study

et al. 2016

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BackgroundThe current generation of older adults reports a higher lifetime prevalence of prescription, over-the-counter, and recreational drug use. The purpose of this analysis is to characterize the drug usage and determine the risk of motor vehicle collision associated with individual medications in a population of drivers ≥65 years.MethodsA case-crossover study was conducted at West Virginia University Healthcare’s facilities using data obtained from the electronic health records (n = 611) of drivers ≥65 years admitted for medical treatment following a motor vehicle collision which occurred between Jan. 1, 2009 and June 30, 2014. Patients’ medication usage 14 days before collision were matched and compared to their medication usage during four control periods prior to collision. Odds ratios were then calculated for the most prevalent individual medications and pharmaceutical sub-classes using conditional logistic regression.ResultsAnalgesic, cardiovascular and gastrointestinal medicines were common. Few drivers tested positive for either licit or illicit drugs. Of those testing positive for drugs, benzodiazepines and opiates were prevalent. Drivers consuming Tramadol (adjusted OR 11.41; 95 % CI 1.27, 102.15) were at a significantly increased risk of motor vehicle collision.ConclusionsOlder adult drivers who have a prescription for this medication may need to be aware of the potential risk. Further research is necessary in a larger, more nationally representative population.

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Influence of St. Johnâs wort on the steadystate pharmacokinetics and metabolism of bosentan

Abstract: SJW increased CYP3A activity but had no consistent effect on bosentan clearance. However, inter-individual changes of the interaction were large, suggesting that close monitoring of bosentan effects may be advisable. The contribution of CYP2C9 to this interaction seems to be minor.

Cited by 14 publications

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Pharmacokinetic Interactions between Herbal Medicines and Drugs: Their Mechanisms and Clinical Relevance

Pharmacokinetic Interactions between Herbal Medicines and Drugs: Their Mechanisms and Clinical Relevance

Understanding drug interactions with St John's wort (Hypericum perforatumL.): impact of hyperforin content

Medication use and the risk of motor vehicle collision in West Virginia drivers 65 years of age and older: a case-crossover study

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Influence of St. Johnâs wort on the steadystate pharmacokinetics and metabolism of bosentan

Abstract: SJW increased CYP3A activity but had no consistent effect on bosentan clearance. However, inter-individual changes of the interaction were large, suggesting that close monitoring of bosentan effects may be advisable. The contribution of CYP2C9 to this interaction seems to be minor.

Cited by 14 publications

References 0 publications

Pharmacokinetic Interactions between Herbal Medicines and Drugs: Their Mechanisms and Clinical Relevance

Pharmacokinetic Interactions between Herbal Medicines and Drugs: Their Mechanisms and Clinical Relevance

Understanding drug interactions with St John's wort (Hypericum perforatumL.): impact of hyperforin content

Medication use and the risk of motor vehicle collision in West Virginia drivers 65 years of age and older: a case-crossover study

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Influence of St. Johnâs wort on the steadystate pharmacokinetics and metabolism of bosentan