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PubMedDate not supplied

Understanding the grapefruit-drug interaction.

The inhibitory interaction of grapefruit juice and CYP3A4 medication metabolism was discovered in 1989. CYP3A4 enzymes are responsible for the metabolism of more than 60% of orally-administered drugs. Grapefruit components inhibit CYP3A4 drug oxidation and P-glycoprotein transportation, allowing more systemic drug bioavailability. This inhibitory interaction should be kept in mind when prescribing drugs that are metabolized by CYP3A4, such as orally administered midazolam, triazolam, and diazepam.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2005

St. John's wort.

St. John's wort has been used to treat a variety of conditions. Several brands are standardized for content of hypericin and hyperforin, which are among the most researched active components of St. John's wort. St. John's wort has been found to be superior to placebo and equivalent to standard antidepressants for the treatment of mild to moderate depression. Studies of St. John's wort for the treatment of major depression have had conflicting results. St. John's wort is generally well tolerated, although it may potentially reduce the effectiveness of several pharmaceutical drugs.

Anthracenes↗
PubMed2005

Protein in St. John's Wort may suppress HIV-1 gene expression. Research suggests interesting possibilities.

St. John's Wort contains a protein that inhibits HIV-1 replication, according to new research. Investigators who have spent more than a decade studying the mechanism of development of neurological disorders in AIDS patients decided to look at the impact St. John's Wort might have on neuronal cells, says Kamel Khalili, PhD, director of the Center for Neurovirology, professor, and acting chair of the department of neuroscience at Temple University's School of Medicine in Philadelphia, PA.

Gene Expression Regulation↗
PubMedDate not supplied

Herbs and dietary supplement use in patients with stage 5 chronic kidney disease.

Herbal products and dietary supplements are complementary and alternative medicine (CAM) therapies that have grown faster than any other CAM treatments. Little information is available about the use of these products in the stage 5 chronic kidney disease (CKD) population. Information on the use, safety, efficacy, adverse effects, and recommended dosages in the nondialysis population are summarized in this article.

Chondroitin Sulfates↗
PubMed2006

Phytotherapy: rarely mentioned spontaneously.

(1) In a German study, very few patients informed their healthcare providers that they were taking St John's wort. (2) St John's wort is an enzyme inducer and can therefore accelerate the elimination of many drugs, including vitamin K antagonists, hormonal contraceptives and immunosuppressants. This leads to a potential loss of efficacy of these drugs when taken in combination with St John's wort. On the other hand, there may be a risk of overdose when St John's wort is withdrawn. (3) In practice, patients must be carefully questioned about all treatments they are taking, including herbal products they do not consider worth mentioning.

Bridged Bicyclo Compounds↗
PubMed2005

[Study on the quantitative and qualitative composition of fungi in dried medicinal plants].

The quantitative and qualitative composition of fungi was determined in selected dried medicinal plants purchased in one of the herbal shops in Szczecin, Poland. The samples examined were as follows: chamomile (Flos Chamomillae), peppermint (Folium Menthae piperitae), lemon balm (Folium Melissae), St. John's wort (Herba Hyperici), and two herbal mixtures. The fungal composition depended on the specified sample. Xerophilic fungi, i.e. Eurotium amstelodami, E. herbariorum, E. rubrum and Wallemia sebi were isolated from dried medicinal plants. E. amstelodami was the predominating species. The prevailing thermophilic and thermotolerant species were Rhizopus microsporus var. rhizopodiformis and Aspergillus fumigatus. Pink and white yeasts were also numerous in some samples. Except for Aspergillus niger, mesophilic and toxigenous species were found to occur infrequently in the samples. However, Aspergillus versicolor was found to occur abundantly in lemon balm.

Chamomile↗
PubMed2006

About the cover: St. John's wort.

Derived from the aerial parts of the plant, St. John's wort generally is used for depression, seasonal affective disorder, and anxiety. Products currently are standardized based on hypericin content, although the hyperforin and bioflavonoid contents are also believed responsible for activity. St. John's wort is metabolized primarily by the liver. Some studies comparing St. John's wort to standard antidepressants suggest that it may be as effective as imipramine or selective serotonin reuptake inhibitors (SSRIs) to treat mild to moderate depression. Results from another clinical trial indicate that the effectiveness of St. John's wort is comparable to paroxetine, an SSRI, in the treatment of moderate to severe depression and is well tolerated. But a meta-analysis shows that data are inconsistent. Studies also show possible efficacy in the management of anxiety and premenstrual syndrome, although additional research is necessary. St. John's wort can interact with many medications owing to induction of cytochrome P-450 3A4 and other mechanisms. Significant interactions include decreased efficacy of antiretrovirals, cyclosporine, tacrolimus, antiepileptics, irinotecan, and other chemotherapeutic agents. Serotonin syndrome may occur when St. John's wort is combined with sympathomimetics, antidepressants, or triptans. Frequently reported adverse events include nausea, headache, constipation, dizziness, confusion, fatigue, and dry mouth. St. John's wort should be used under medical supervision.

Antidepressive Agents↗
PubMed2004

[Highly dosed St. John's wort extract improves quality of life].

AIM: Aim of the post-marketing surveillance was to investigate if the single-dose-administration of highlydosed St. John's Wort extract improves quality of life of patients with depressive symptoms. METHOD: During a twelve week treatment 4337 patients with depression were observed. Mental and physical state of health were documented using the SF-12-sumscore as a measure for quality of life. Further efficacy and tolerability was rated by physician and patient. Adverse drug reactions were documented as well. RESULTS: During therapy the mental and the physical SF-12-sumscore had improved significantly. At the end ofthe observation the values rise up to the norm. About 80 percent of the physicians and patients marked the drug's efficacy as good or very good. Tolerability was assessed as good or very good in more than 95%. CONCLUSION: A post-marketing surveillance including 4337 depressive patients shows that a single-dose therapy with highly dosed St. John's Wort extract causes to improve significantly the quality of life. The patients suffered from mild to moderate depression.

Adult↗