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Pronunciations cyclosporine digoxin indinavir protease inhibitors ritonavir uterus warfarin

Background: The reddish substance in the plant's flowers contains hypericin, which is the main active component.

Medicinal Claims: In many small, mostly short-term, moderately well-designed studies, St. John's wort relieved symptoms in people with mild to moderate depression. However, in a recent large, well-designed study, St. John's wort was found to be ineffective in treating major depression.

St. John's wort has been used in the treatment of HIV infection and vitiligo, but its effectiveness in treating these disorders is unproved.

Possible Side Effects: When used as directed, St. John's wort does not seem to have the side effects or interactions with foods containing tyramine that can occur with other monoamine oxidase inhibitors (MAOIs (see Depression and Mania: Drug Therapy). It can make the skin very sensitive to sunlight (photosensitive). Pregnant women should not take this supplement because it increases muscle tone in the uterus and thus may increase the risk of a miscarriage. St. John's wort may interact with oral contraceptives; protease inhibitors (such as indinavirSome Trade Names
CRIXIVAN
and ritonavirSome Trade Names
NORVIR
), which are used to treat HIV infection; MAOIs and other antidepressants; the immunosuppressant cyclosporineSome Trade Names
SANDIMMUNE
NEORAL
; digoxinSome Trade Names
LANOXIN
; iron supplements; and the anticoagulant warfarinSome Trade Names
COUMADIN
.

Last full review/revision February 2003