St. John's Wort

Recently Answered

• QHow can I take St. John’s Wort?

  1 Answer

  A

  

  A Stacy Wiegman, PharmD , Pharmacy, answered

  St. John's Wort is available in oral forms such as capsules, tablets and liquid extracts, and it is also available in topical forms that are only used externally. Some forms of the products can be brewed as a tea to drink. You should take the pill forms with a full glass of water. Do not take more of this product than directed because too much can be hazardous. Do not use different forms of St. John's Wort at the same time, unless you are explicitly directed by your health care provider, since you increase the chance of overdose.
  
  
• QWhat herbs and supplements can interact with St. John's wort?

  1 Answer

  A

  

  A Dr. Tieraona Low Dog, MD , General Practice, answered

  

  St. John's wort has been shown to interact with many prescription medications, but less so with other supplements. In this video, integrative medicine specialist Tieraona Low Dog, MD, explains the guidelines to keep in mind about St. John's wort.
• QWhat questions should I ask my pharmacist about St. John’s wort?

  1 Answer

  A

  

  A Stacy Wiegman, PharmD , Pharmacy, answered

  Ask your pharmacist if St. John's wort may interact with any of the other medications you may be taking, especially drugs for depression, birth control, heart problems, seizures or HIV. Also ask your pharmacist if there are any side effects you should be concerned about.
  
  St. John's wort may help alleviate mild depression, but it should not be taken for another depression-related condition, bipolar disorder. So you may also want to ask your pharmacist about any conditions for which you should not be taking this dietary supplement.
  
• QWho should use St. John’s Wort?

  1 Answer

  A

  

  A Stacy Wiegman, PharmD , Pharmacy, answered

  St. John's Wort is used to treat mild to moderate depression in adults. It is also used to treat other conditions in adults, such as anxiety, sleep disorders, and infection. St. John's Wort has additionally been topically utilized in adults to treat muscle pain, inflammation and wounds of the skin, and burns.

• QWhat is St. John's wort extract (SJWE)?

  2 Answers

  A

  

  A Stacy Wiegman, PharmD , Pharmacy, answered

  Many oral supplements of St. John's wort are actually extracts. These are formulations containing the herb's active ingredients -- including hypericin and/or hyperforin -- in concentrated form.

  See All 2 Answers
• QShould I tell my pharmacist if I am taking medications and St. John’s wort?

  1 Answer

  A

  

  A Stacy Wiegman, PharmD , Pharmacy, answered

  St. John's wort can interact with a wide variety of medications, so have a conversation with your doctor and pharmacist about any other medications you are taking. Be sure to mention if you are currently taking birth control pills, prescription antidepressants, heart medications such as digoxin, anticoagulants like warfarin, HIV medications such as protease inhibitors or seizure medications such as phenytoin or phenobarbital. Taking St. John's wort while you are also taking a prescription antidepressant may increase your risk of a condition called serotonin syndrome, which can be very serious. 
• QHow soon after taking St. John’s wort might depression symptoms improve?

  1 Answer

  A

  

  A Stacy Wiegman, PharmD , Pharmacy, answered

  Like a prescription antidepressant, St. John's wort will not relieve depression symptoms immediately. It is not well understood how St. John's wort works, but it appears to affect a number of brain neurotransmitters such as serotonin. In one study of more than 3,000 patients who were given an extract of St. John's wort three times a day, about 30 percent felt an improvement in depression after four weeks.
• QWhat dosage of St. John's wort is typically used for adults?

  1 Answer

  A

  

  A Dr. Michael T. Murray, ND , Naturopathic Medicine, answered

  

  The dosage for the SJWE standardized to contain 0.3 percent hypericin and 3 to 5 percent hyperforin is typically 900 mg per day for mild depression and 1,800 mg per day for moderate to severe depression. Initially the dosage was spread out during the day, but recent studies indicate that a single daily dose is preferable.

  

  Find out more about this book:

  What the Drug Companies Won't Tell You and Your Doctor Doesn't Know: The Alternative Treatments That May Change Your Life--and the Prescriptions That Could Harm You
  Buy book
• QIs St. John’s wort regulated by the FDA?

  1 Answer

  A

  

  A Stacy Wiegman, PharmD , Pharmacy, answered

  St. John's wort is classified by the U.S. Food and Drug Administration (FDA) as a dietary supplement, not a drug. The FDA does not test it for safety and effectiveness, although it can take action if there is a safety issue. The FDA has not evaluated St. John's wort as a treatment for any medical condition. It is up to you to determine whether you believe it is effective and whether the product you purchase is safe.
• QWhat herbs and supplements can interact with St. John's wort?

  1 Answer

  A

  

  A RealAge answered

  St. John's wort is one of the better-studied herbs because of its reported effectiveness; it has also been found to interact with a large number of drugs. St. John’s wort makes some drugs stronger, others weaker. It should not be used if you are taking the following:
  
  abiraterone; aliskiren; almotriptan; alprazolam; amiodarone; amitriptyline; amoxapine; apixaban; apremilast; aprepitant; atazanavir; avanafil; axitinib; bedaquiline; bexarotene; boceprevir; bortezomib; bosutinib; cabozantinib; calcitriol; cariprazine; ceritinib; cholecalciferol; citalopram; clarithromycin; clomipramine; clopidogrel; cobicistat; cobimetinib; crizotinib; cyclosporine; dabigatran etexilate; dabrafenib; daclatasvir; darunavir; dasatinib; delavirdine; desipramine; desogestrel; dextromethorphan; diazepam; dienogest; digoxin; diltiazem; docetaxel; dolutegravir; doxepin; doxercalciferol; dronedarone; drospirenone; edoxaban; efavirenz; elbasvir; eletriptan; eliglustat; elvitegravir; enzalutamide; erlotinib; escitalopram; esomeprazole; estradiol; ethinyl estradiol; ethynodiol; etonogestrel; etravirine; everolimus; exemestane; fexofenadine; finasteride; flibanserin; fluoxetine; fluvoxamine; fosamprenavir; fosaprepitant; frovatriptan; grazoprevir; ibrutinib; idelalisib; ifosfamide; imatinib imipramine; indinavir; irinotecan; isavuconazonium sulfate; isocarboxazid; itraconazole; ivabradine; ivacaftor; ixabepilone; ixazomib; ketoconazole; lamotrigine; lapatinib; ledipasvir; levonorgestrel; levonorgestrel; linagliptin; linezolid; lopinavir/ritonavir; lurasidone; macitentan; maraviroc; medroxyprogesterone; mestranol; methotrexate; midazolam; mifepristone; naloxegol; naratriptan; nefazodone; nelfinavir; netupitant; nevirapine; nilotinib; nintedanib; norelgestromin; norethindrone; norgestimat; norgestrel; nortriptyline; olaparib; omeprazole; ondansetron; osimertinib; oxycodone; paclitaxel; palbociclib; paliperidone; panobinostat; paritaprevir; paroxetine; pazopanib; pegylated interferon α; perampanel; phenelzine; pimavanserin; ponatinib; praziquantel; procarbazine; protriptyline; quinidine; ramelteon; ranolazine; rasagiline; regorafenib; reserpine; rilpivirine; ritonavir; rivaroxaban; rizatriptan; rolapitant; romidepsin; saquinavir; selegiline; selegiline transdermal; sertraline; sildenafil; simeprevir; sofosbuvir; sonidegib; sumatriptan; sunitinib; tadalafil; talinolol; tasimelteon; telithromycin; temsirolimus; tenofovir alafenamide; ticagrelor; tipranavir; tofacitinib; tolvaptan; trabectedin; tranylcypromine; trazodone; triazolam; ulipristal; vandetanib; velpatasvir; vemurafenib; venetoclax; venlafaxine; vilazodone; vinblastine; vincristine; vinorelbine; vorapaxar; voriconazole; warfarin; zolmitriptan.
  
  Avoid alcohol while taking St. John’s wort.
  
  Other drugs that should be avoided while taking St. John’s wort include: acetaminophen; afatinib; aminophylline; amlodipine; aripiprazole; aripiprazole lauroxil; brexpiprazole; buprenorphine; carbamazepine; caspofungin; cinacalcet; ethosuximide; felodipine; fentanyl; gefitinib; guanfacine; hydrocodone; isradipine; methadone; nicardipine; nifedipine; nimodipine; nisoldipine; quinidine (antiarrhythmic); repaglinide; sirolimus; tacrolimus; theophylline; tiagabine; verapamil.
  
  Other drugs and herbs that may cause interactions include: 5-HTP; aldesleukin; alfentanil; apomorphine; armodafinil; artemether/lumefantrine; atorvastatin; betamethasone; bromocriptine; budesonide; butabarbital; butalbital; calendula; capsicum; ciprofloxacin; clorazepate; clozapine; cocaine topical; conivaptan; cortisone; cyclobenzaprine; dantrolene; dapsone; darifenacin; demeclocycline; desvenlafaxine; dexamethasone; docetaxel; doxycycline; drospirenone; duloxetine; eslicarbazepine acetate; estradiol; estrogens, esterified; estropipate; eszopiclone; ethinyl estradiol; etoposide; ezogabine; gemifloxacin; German chamomile; ginseng, glicazide; Siberian; goldenseal; gotu kola; hydrocortisone; hydroxyprogesterone; imatinib; isotretinoin; kava; lemon balm; levofloxacin; levomilnacipran; levonorgestrel; lorcaserin; lovastatin; medroxyprogesterone; melatonin; meperidine; meprobamate; methohexital; methylene blue; methylprednisolone; milnacipran; minocycline; mirtazapine; mitotane; modafinil; montelukast; morphine liposomal; moxifloxacin; norethindrone; norgestimate; ofloxacin; oxcarbazepine; passionflower; pentazocine; pentobarbital; phenobarbital; pimozide; pomalidomide; posaconazole; pramipexole; prednisolone; prednisone; primidone; progesterone; quinine; risperidone; ropinirole; rosuvastatin; rotigotine transdermal; rufinamide; ruxolitinib; secobarbital; simvastatin; solifenacin; sorafenib; sufentanil; sulfadiazine; sulfadoxine; sulfamethoxazole; sulfasalazine; sulfisoxazole; suvorexant; tamoxifen; teniposide; tetrabenazine; tetracycline; thiotepa; tinidazole; tolcapone; topiramate; toremifene; tramadol; tretinoin; triamcinolone; trimipramine; valerian; valproic acid; vortioxetine; yohimbe; zaleplon; ziconotide; zolpidem; zonisamide.
  
  Speak with your healthcare provider about all medications and drugs you are taking before beginning a new supplement regimen.