ReviewBritish journal of pharmacology2020
Clinical relevance of St. John's wort drug interactions revisited.
Review in British journal of pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 3 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
66 citing papers in PubMed, 3 syntheses or guidelines pooled it, 160 citations in OpenAlex.
- Phytochemicals in the treatment of patients with depression: a systemic review.Frontiers in psychiatry · 2024Pooled it
- Pooled it
- Current state of research on the clinical benefits of herbal medicines for non-life-threatening ailments.Frontiers in pharmacology · 2023Pooled it
- Natural Product Use Among Veterans with Chronic Pain: A Qualitative Study of Attitudes and Communication with Healthcare Providers.Journal of general internal medicine · 2024Trial
- Hyperforin as a Multifunctional Specialized Metabolite of Natural Origin for Chronic Diseases: From Molecular Mechanisms to Clinical Translation.Current issues in molecular biology · 2026Review
- Safety and Efficacy of Natural and Conventional Psychiatric Treatments: A Comparative Review of Mushroom-Derived Compounds and Medicinal Plants in the Management of Mental Disorders.Molecules (Basel, Switzerland) · 2026Review
- Defined Natural Products as Adjunctive Therapies: Evidence-Gated Polypharmacology Across Molecular Targets, Human Exposure, Clinical Signals, and Safety Boundaries.International journal of molecular sciences · 2026Review
- Article
- A Framework for Developing Intake and Use Guidance for Dietary Supplement Bioactives.Advances in nutrition (Bethesda, Md.) · 2026Review
- Mendelian Randomization Identifies Lipidomic Signatures of Depression Risk That Are Partly Reflected in Cortisol-Induced Membrane Remodeling and Modulated by St. John's Wort Extract (Ze 117).International journal of molecular sciences · 2026Article
- Enhancing therapeutic strategies and drug development for patients with kidney disease.Expert opinion on drug safety · 2026Review
- Effects of combining Shugan Jieyu capsule treatment with group psychological counseling on alexithymia in hemodialysis patients.Frontiers in pharmacology · 2026Article
- Pharmacological Complexities of Herbal Medicinal Extracts: A Review of Bioavailability, Interactions, and Standardization.Current drug metabolism · 2026Review
- Potential Drug Interactions in Psychiatric Patients Undergoing Pangenotypic Therapy for Hepatitis C Virus Infection.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Herbal Medicines and Drugs Interactions: Cytochrome P450 Responsibility.Current medicinal chemistry · 2026Review
- Hypericin and hyperforin from St. John's Wort are potent intestinal UGT inhibitors with distinct binding modes: mechanistic and quantitative prediction of clinical drug-drug interaction risk.Frontiers in pharmacology · 2026Article
- St. John's Wort for Depression: From Neurotransmitters to Membrane Plasticity.International journal of molecular sciences · 2025Review
- Effects of Botrychium ternatum (Thunb) Sw. On Cytochrome P450 Activities in Rats.Pharmacology research & perspectives · 2025Article
- When Nature Meets Oncology: Unraveling Herb-Drug Interactions in Cancer Therapy.International journal of molecular sciences · 2025Review
- Polyprenylated Acylphloroglucinols fromPharmaceuticals (Basel, Switzerland) · 2025Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The first clinically relevant reports of preparations of St. John's wort (SJW), a herbal medicine with anti-depressant effects, interacting with other drugs, altering their bioavailability and efficacy, were published about 20 years ago. In 2000, a pharmacokinetic interaction between SJW and cyclosporine caused acute rejection in two heart transplant patients. Since then, subsequent research has shown that SJW altered the pharmacokinetics of drugs such as digoxin, tacrolimus, indinavir, warfarin, alprazolam, simvastatin, or oral contraceptives. These interactions were caused by pregnane-X-receptor (PXR) activation. Preparations of SJW are potent activators of PXR and hence inducers of cytochrome P450 enzymes (most importantly CYP3A4) and P-glycoprotein. The degree of CYP3A4 induction correlates significantly with the hyperforin content in the preparation. Twenty years after the first occurrence of clinically relevant pharmacokinetic drug interactions with SJW, this review revisits the current knowledge of the mechanisms of action and on how pharmacokinetic drug interactions with SJW could be avoided. LINKED ARTICLES: This article is part of a themed section on The Pharmacology of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.6/issuetoc.
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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.