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Drug Guide    S   St. John's Wort

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   St. John's Wort

St. John's Wort
Oral


St. John's wort has been used for depression.Some herbal/dietary supplement products have been found to contain possibly harmful impurities/additives. Check with your pharmacist for more details about the brand you use.The FDA has not reviewed this product for safety or effectiveness. Consult your doctor or pharmacist for more details.

 
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 St. John's Wort images:

OverviewPhotosHow To UseSide EffectsPrecautionsMissed DoseDrug Interactions
St. John's Wort

Uses
St. John's wort has been used for depression.Some herbal/dietary supplement products have been found to contain possibly harmful impurities/additives. Check with your pharmacist for more details about the brand you use.The FDA has not reviewed this product for safety or effectiveness. Consult your doctor or pharmacist for more details.
Notes
  • Keep all regular medical and laboratory appointments.Check the product labeling carefully to make sure you have the correct product.
  • St.
  • John's wort is a species called Hypericum perforatum and should not be confused with other Hypericum species.

Storage
  • Refer to storage information printed on the package.
  • If you have any questions about storage, ask your pharmacist.
  • Keep all medications and herbal products away from children and pets.


How To Use
  • Take this product by mouth as directed.
  • Follow all directions on the product package.
  • If you are uncertain about any of the information, consult your doctor or pharmacist.
  • Do not take more than the recommended amount.
  • It may take about 3 weeks of regular use before you notice the benefits of this product.Do not suddenly stop taking this product.
  • Some conditions may become worse when this product is abruptly stopped.
  • You may need to gradually reduce your dose.
  • Consult your doctor or pharmacist for details.If your condition persists or worsens, or if you think you may have a serious medical problem, seek immediate medical attention.

Side Effects
  • Trouble sleeping, restlessness, upset stomach, dizziness, headache, or numbness/tingling of the hands/feet may occur.
  • If any of these effects persist or worsen, contact your doctor or pharmacist promptly.Tell your doctor immediately if this unlikely but serious side effect occurs: a sunburn-like skin reaction (increased sun sensitivity).Tell your doctor immediately if any of these rare but very serious side effects occur: black/bloody/tarry stools, vomit that looks like coffee grounds, easy bruising/bleeding.This product may rarely cause a very serious condition called serotonin syndrome.
  • The risk increases when this product is used with certain drugs such as "triptans" used to treat migraine headaches (e.g., sumatriptan, eletriptan), certain antidepressants including SSRIs (e.g., citalopram, paroxetine) and SNRIs (e.g., duloxetine, venlafaxine), lithium, tramadol, tryptophan, or a certain drug to treat obesity (sibutramine).
  • See also Drug Interactions section.
  • Before taking this product, tell your doctor if you take any of these medications.
  • Serotonin syndrome may be more likely when you start or increase the dose of any of these medications.
  • Seek immediate medical attention if you develop any of the following symptoms: unusual mental/mood changes (e.g., strange thoughts, unusual excitement, extreme anxiety, confusion), severe dizziness, severe headache, fast heartbeat, unexplained fever, sweating, severe nausea/vomiting/diarrhea, twitching muscles.A very serious allergic reaction to this product is rare.
  • However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching, swelling, severe dizziness, trouble breathing.If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions
  • Before taking St.
  • John's wort, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.If you have any of the following health problems, consult your doctor or pharmacist before using this product: personal or family history of bipolar/manic-depressive disorder.This product may make you more sensitive to the sun.
  • Avoid prolonged sun exposure, tanning booths, and sunlamps.
  • Use a sunscreen and wear protective clothing when outdoors.Liquid forms of this product may contain sugar and/or alcohol.
  • Caution is advised if you have diabetes, alcohol dependence, or liver disease.
  • Ask your doctor or pharmacist about using this product safely.Before having surgery, tell your doctor or dentist that you are using this product.St.
  • John's wort is not recommended for use during pregnancy.
  • Consult your doctor before using this product.It is not known if St.
  • John's wort passes into breast milk.
  • Consult your doctor before breast-feeding.

Missed Dose
  • If you miss a dose, take it as soon as you remember.
  • If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule.
  • Do not double the dose to catch up.

Drug Interactions
  • Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) within 2 weeks before, during, and after using St.
  • John's wort.
  • In some cases a serious (possibly fatal) drug interaction may occur.St.
  • John's wort interacts with many medications and products.
  • The following drugs are just some of the products that may interact with St.
  • John's wort.Before using this product, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: drugs used to prevent organ rejection (e.g., cyclosporine, sirolimus, tacrolimus), drugs used to treat cancer (e.g., cyclophosphamide, etoposide, irinotecan, paclitaxel, tamoxifen), heart medications (e.g., digoxin, beta blockers such as metoprolol, calcium channel blockers such as diltiazem), anti-seizure drugs (e.g., carbamazepine, phenytoin, phenobarbital), tricyclic antidepressants (e.g., amitriptyline, nortriptyline), sympathomimetic drugs (e.g., albuterol, phenylephrine), drugs used to treat HIV infection such as protease inhibitors (e.g., indinavir) and non-nucleoside reverse transcriptase inhibitors (NNRTIs such as delavirdine, efavirenz, nevirapine), drugs that can cause bleeding/bruising (e.g., antiplatelet drugs such as clopidogrel, "blood thinners" such as warfarin and heparin, NSAIDs such as ibuprofen).Also tell your doctor if you take any other products/drugs that increase serotonin, such as bromocriptine, buspirone, dextromethorphan, meperidine, propoxyphene, phentermine, ergots such as dihydroergotamine, street drugs such as MDMA/"ecstasy," amphetamine.
  • (See also Side Effects section.)Aspirin can increase the risk of bleeding when used with this product.
  • If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise.
  • Discuss the risks and benefits with your doctor.This product may decrease the effectiveness of birth control that contains estrogen (pills, patch, ring).
  • This can result in pregnancy.
  • Ask your doctor or pharmacist for details.
  • Discuss whether you should use additional reliable birth control methods while taking this product.The interactions listed above are not a complete listing of all possible drug interactions.
  • St.
  • John's wort may also interact with many other drugs by affecting how they are absorbed by your body or removed from your body.
  • These effects may change how well these other drugs work.
  • Therefore, before using St.
  • John's wort, talk with your doctor or pharmacist about all medications and products you take.Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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