Second thoughts about safety of St John's wort

Ernst, Edzard

doi:10.1016/s0140-6736(99)00418-3

Cited by 283 publications

(130 citation statements)

References 9 publications

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“…Its active constituent hyperforin is a well-known activator of the pregnane X receptor, 128 which results in enhanced expression of the drug efflux transporter ABCB1 (P-glycoprotein) 129 and induction of CYP3A4 (Table 3), an enzyme involved in metabolism of the majority of prescription medications used in cardiovascular practice. 130 Thus, potentially serious adverse reactions can occur from coadministration with drugs metabolized through CYP3A4 or transported by P-glycoprotein. Hypotension and delayed emergence from anesthesia were associated with prior use of St. John's wort.…”

Section: Weak Inducers (20-50% ↓ In Auc)mentioning

confidence: 99%

Essentials of Herb-Drug Interactions in the Elderly With Cardiovascular Disease

Sultan¹,

Maria²,

Ali³

et al. 2015

Journal of Patient-Centered Research and Reviews

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Section: Weak Inducers (20-50% ↓ In Auc)mentioning

confidence: 99%

Essentials of Herb-Drug Interactions in the Elderly With Cardiovascular Disease

Sultan¹,

Maria²,

Ali³

et al. 2015

Journal of Patient-Centered Research and Reviews

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“…It is a flowering plant species that acts as a medicinal herb. It is sold globally for its major benefit and also acts as a good remedy for major depressive disorder (12,13 (14).…”

Section: St John's Wortmentioning

confidence: 99%

“…The extracts from St. John's wort are successful and satisfactorily welltolerated in the treatment of both gentle to-low extreme depression (14) and major depression (15) (10). The main drug metabolizing enzyme CYP3A gets effected by this herb and it stimulate this enzyme and P glyco protein (P-gp), adenosine triphosphate-dependent transport is responsible for amplified drug elimination (16)(17)(18) it is a drug that curbs its activity for its treatment (10,16,19).…”

Section: St John's Wortmentioning

confidence: 99%

St John's Wort in the treatment against Major Depression Disorder

Bhat¹,

Wani²,

Ara³

2015

Ulutas Med J

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Background: Depression is a complex mood disorder with many types and treated in a number of ways. There are large numbers of synthetic drugs which are used in treating major depressive disorder. However, they are also found to have bad impact on the health of a patient. Depression is multifactorial phenomenon, in which hormonal and neurotransmitter imbalance plays imperative role in its causation. Though large number of pharmaceutical drugs is available, but they also pose serious threat due to extended use as serious side effects also develop. Conclusion:It is very important to look for antidepressants from natural sources which are advantageous, less hazardous and has least side effects on human health. This article aims to focus on specific natural antidepressant St John's Wort and how it can act as alternative medicine exhibiting the potential for the treatment of depression.

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“…A number of clinically important drug interactions have been reported in patients taking SJW. Induction of CYP3A4 enhances the metabolism of many therapeutic drugs, such as amitriptyline, cyclosporine, digoxin, indinavir, irinotecan, warfarin, phenprocoumon, alprazolam, dextrometorphane, simvastatin, and oral contraceptives [41][42][43][44][45] . Pregnenolone 16α-carbonitrile (PCN), which is a synthetic antiglucocorticoid, induces the CYP3A family [46,47] .…”

Section: Implications Of Pxr In Ddismentioning

confidence: 99%

Role of the nuclear pregnane X receptor in drug metabolism and the clinical response

2015

Receptors Clin Investig

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The pregnane X receptor (PXR) is an orphan nuclear receptor that regulates the expression of phase I and phase II drug metabolizing enzymes and transporters involved in the absorption, distribution, metabolism, and elimination of xenobiotics. PXR is expressed predominantly in the liver and intestine and resembles cytochrome P450s (CYPs), which is a phase I drug metabolizing enzyme. It is estimated that CYP 3As and CYP2Cs metabolize > 50% of all prescription drugs. PXR upregulates gene expression of these CYPs. Therefore, PXR plays a crucial role detoxifying xenobiotics and could potentially have effects on drug-drug interactions. PXR is reportedly responsible for activating a variety of target genes through cross-talk with other nuclear receptors and coactivators at transcriptional and translation levels. Recent findings have demonstrated the regulatory role of PXR and show the potential use of a PXR antagonist during drug therapy. In addition, genetic variations in the PXR gene are associated with the pharmacological effects of several drugs, and inter-individual differences in the clinical response are likely to be understood through these PXR polymorphisms. Many approaches have been used to explain the PXR regulatory mechanisms, such as microRNA-mediated PXR post-translational regulation and diverse PXR haplotype analysis. Understanding these PXR polymorphisms may lead to improving personalized therapeutic treatments.Keywords: pregnane X receptor; drug metabolizing enzyme; polymorphism; personalized therapeutic treatment To cite this article: Jung Yeon Moon, et al. Role of the nuclear pregnane X receptor in drug metabolism and the clinical response. Receptor Clin Invest 2015; 2: e996.

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Second thoughts about safety of St John's wort

Cited by 283 publications

References 9 publications

Essentials of Herb-Drug Interactions in the Elderly With Cardiovascular Disease

Essentials of Herb-Drug Interactions in the Elderly With Cardiovascular Disease

St John's Wort in the treatment against Major Depression Disorder

Role of the nuclear pregnane X receptor in drug metabolism and the clinical response

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