SynthesisBMJ (Clinical research ed.)2004
Interaction of St John's wort with conventional drugs: systematic review of clinical trials.
Synthesis in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- Interactions between herbal medicines and prescribed drugs: an updated systematic review.Drugs · 2009Pooled it
- The effect of St John's wort extracts on CYP3A: a systematic review of prospective clinical trials.British journal of clinical pharmacology · 2006Pooled it
- Pharmacodynamic interaction of warfarin with cranberry but not with garlic in healthy subjects.British journal of pharmacology · 2008Trial
- Interaction between a commercially available St. John's wort product (Movina) and atorvastatin in patients with hypercholesterolemia.European journal of clinical pharmacology · 2007Trial
- Effects of treatment with a commercially available St John's Wort product (Movina) on cholesterol levels in patients with hypercholesterolemia treated with simvastatin.Scandinavian journal of primary health care · 2007Trial
- Potential herb‒drug interactions between anti-COVID-19 drugs and traditional Chinese medicine.Acta pharmaceutica Sinica. B · 2023Review
- Clinical relevance of potential self-medication drug interactions in antineoplastic and immune-modulating therapy among online pharmacy customers.Therapeutic advances in drug safety · 2023Article
- Drug metabolism and pharmacokinetics of praziquantel: A review of variable drug exposure during schistosomiasis treatment in human hosts and experimental models.PLoS neglected tropical diseases · 2020Review
- Article
- Extended Intake of Mulberry Leaf Extract Delayed Metformin Elimination via Inhibiting the Organic Cation Transporter 2.Pharmaceutics · 2020Article
- Review
- Inhibitory Influence of Panax notoginseng Saponins on Aspirin Hydrolysis in Human Intestinal Caco-2 Cells.Molecules (Basel, Switzerland) · 2018Article
- Influence of Shenxiong Glucose Injection on the Activities of Six CYP Isozymes and Metabolism of Warfarin in Rats Assessed Using Probe Cocktail and Pharmacokinetic Approaches.Molecules (Basel, Switzerland) · 2017Article
- Prevalence and Predictors of Herbal Medicine Use Among Adults in the United States.Journal of patient experience · 2017Article
- Therapeutic Effects of Phytochemicals and Medicinal Herbs on Depression.BioMed research international · 2017Review
- Interactions between antidiabetic drugs and herbs: an overview of mechanisms of action and clinical implications.Diabetology & metabolic syndrome · 2017Review
- Clinically and pharmacologically relevant interactions of antidiabetic drugs.Therapeutic advances in endocrinology and metabolism · 2016Review
- St. John's Wort Attenuates Colorectal Carcinogenesis in Mice through Suppression of Inflammatory Signaling.Cancer prevention research (Philadelphia, Pa.) · 2015Article
- Understanding CAM Natural Health Products: Implications of Use Among Cancer Patients and Survivors.Journal of the advanced practitioner in oncology · 2013Review
- Underestimating the toxicological challenges associated with the use of herbal medicinal products in developing countries.BioMed research international · 2013Review
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the methodological quality of clinical trials that examined possible interactions of St John's wort with conventional drugs, and to examine the results of these trials.
designSystematic review. DATA SOURCES: Electronic databases from inception to April 2004, reference lists from published reports, and experts in the field. STUDY SELECTION: Eligible studies were prospective clinical trials evaluating the pharmacokinetic effect of St John's wort on the metabolism of conventional drugs. DATA EXTRACTION: Two reviewers selected studies for inclusion and independently extracted data. DATA SYNTHESIS: 22 pharmacokinetic trials studied an average of 12 (SD 5) participants; 17 trials studied healthy volunteers and five studied patients. Most (17) studies used a "before and after" design; four studies used control groups other than the active group. Three studies randomised the sequence of administration or the participants to study arms or periods; three studies blinded participants or investigators. In 15 trials, investigators independently assayed the herb. Of 19 trials with available plasma data, three found no important interaction (change in area under the curve < 20%) and 17 found a decrease in systemic bioavailability of the conventional drug; in seven studies the 95% confidence interval excluded a decrease of < 20%.
conclusionClinicians and patients should beware of possible decreases in the systemic bioavailability of conventional drugs when taken concomitantly with St John's wort.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.