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Their interpretation of the data is that St. John's Wort induces hepatic enzymes with resultant lowering of serum levels of protease inhibitors and other drugs. The conseqences of this may be to reduce the effectiveness of antivirals against viral infections such as HIV, to precipitate organ rejection in the case of immunosuppressants, or for pregnancy to occur despite use of the contraceptive medication as directed. The research report by Piscitelli, et al., can be found in the February 12th issue of The Lancet. Any observations of worrisome drug interactions should be reported to the FDA's MedWatch program at 1-800-FDA-1088 (fax 1-800-FDA-0178). Primary online sources can be found at:
Date: Fri, 11 Feb 2000 19:58:39 -0500 From: "Marshall, Louise (NIMH)" <lmarsha1@mail.nih.gov> Subject: PUBLIC ALERT ON ST. JOHN'S WORT Sender: owner-nimh-e-news@LIST.NIH.GOV To: List NIMH-E-NEWS <NIMH-E-NEWS@LIST.NIH.GOV> MIME-version: 1.0 The National Institute of Mental Health (NIMH) alerts the public to concerns about interactions between St. John's wort, an herbal product used to treat depression, and indinavir, a protease inhibitor, and perhaps other protease inhibitors used in the treatment of HIV. Adverse interactions have also been reported with cyclosporine, a drug used to reduce the risk of organ transplant rejection and again possibly with other immunosuppressant drugs. St. John's wort appears to lower the blood plasma level of protease inhibitors and immunosuppressant drugs. NIMH and National Center for Complementary and Alternative Medicine are conducting a clinical trial <http://hypericum.rti.org/index.html> of the safety and efficacy of St. John's wort. Please view the NIH News Release <http://www.nih.gov/news/pr/feb2000/wgmcc-10.htm> and FDA Public Health Advisory for Health Care Professionals <http://www.fda.gov/cder/drug/advisory/stjwort.htm> for more information. ================================================================== Date: Mon, 14 Feb 2000 13:36:17 -0500 From: "Marshall, Louise (NIMH)" <lmarsha1@mail.nih.gov> Subject: Revised Breaking News and Newest Items Added to the NIMH Website - February 14, 2000 Sender: owner-nimh-e-news@LIST.NIH.GOV To: List NIMH-E-NEWS <NIMH-E-NEWS@LIST.NIH.GOV> MIME-version: 1.0 Breaking News (Revised) PUBLIC ALERT ON ST. JOHN'S WORT Adverse interactions have been reported between St John's wort (hypericum), an herbal product used to treat depression, and two drugs: indinavir, a protease inhibitor used to treat HIV and cyclosporine, a drug used to reduce the risk of organ transplant rejection. Potentially dangerous changes in drug effects can occur when medications such as cyclosporine (Neoral, Sandimmune), digoxin (Lanoxin, Lanoxicaps) and warfarin (Coumadin) are taken with hypericum extracts. Hypericum extracts can decrease the blood levels of antiretroviral medications that are used in the treatment of HIV infection, thus making these drugs less effective. Recent data show that the plasma levels of the protease inhibitor indinavir (Crixivan) were reduced by more than 50% by hypericum (St. John's wort) products. NIMH and National Center for Complementary and Alternative Medicine are conducting a clinical trial <http://hypericum.rti.org/index.html> of the safety and efficacy of St. John's wort. Please view the NIH News Release <http://www.nih.gov/news/pr/feb2000/wgmcc-10.htm> and FDA Public Health Advisory for Health Care Professionals <http://www.fda.gov/cder/drug/advisory/stjwort.htm> for more information. ______________________________________________________________________
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