Literature DB >> 19015839

St John's wort extract (Ze 117) does not alter the pharmacokinetics of a low-dose oral contraceptive.

Liane Will-Shahab1, Steffen Bauer, Ullrich Kunter, Ivar Roots, Axel Brattström.   

Abstract

PURPOSE: St John's wort (Hypericum perforatum) is an herbal remedy that is widely used in the treatment of depression. Recent clinical data have demonstrated that St John's wort extracts interfere with the action of various drugs and possibly also with combined oral contraceptives. Therefore, we investigated the effects of a St John's wort extract (Ze 117) with low hyperforin content on the pharmacokinetics of ethinylestradiol and 3-ketodesogestrel.
METHOD: Sixteen healthy female volunteers, who had taken a low-dose oral contraceptive (Lovelle contains 0.02 mg ethinylestradiol + 0.15 mg desogestrel) for at least 3 months, participated in the study. Pharmacokinetic data (AUC, C(max), t(max)) were determined the day before (reference) and after (test) a 14-day period of Ze 117 intake (250 mg twice daily).
RESULTS: Before the co-administration of Ze 117 on day 7, the geometric mean (geometric coefficient of variation) for the AUC(0-24) of ethinylestradiol was 152.53 pg.h/ml (87.39%) and after co-administration on day 21 it was 196.57 pg.h/ml (78.14%). The respective values for ketodesogestrel were 36.37 pg.h/ml (34.18%) and 41.12 pg.h/ml (34.36%). The mean of individual ratios (reference-to-test) of log-transformed AUC values (90% confidence interval) were 0.951 (0.915-0.986) for ethinylestradiol and 0.968 (0.944-0.992) for ketodesogestrel indicating a small gain [corrected] in bioavilability, but bioequivalence nevertheless.
CONCLUSION: These results indicate that the recommended dose of the hypericum extract Ze117, which has a low hyperforin content, does not interact with the pharmacokinetics of the hormonal components of the low-dose oral contraceptive.

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Year:  2008        PMID: 19015839     DOI: 10.1007/s00228-008-0587-2

Source DB:  PubMed          Journal:  Eur J Clin Pharmacol        ISSN: 0031-6970            Impact factor:   2.953


  36 in total

1.  Activity of the pituitary-ovarian axis in the pill-free interval during use of low-dose combined oral contraceptives.

Authors:  A M van Heusden; B C Fauser
Journal:  Contraception       Date:  1999-04       Impact factor: 3.375

2.  Effect of St. John's wort (Hypericum perforatum) on cytochrome P-450 2D6 and 3A4 activity in healthy volunteers.

Authors:  J S Markowitz; C L DeVane; D W Boulton; S W Carson; Z Nahas; S C Risch
Journal:  Life Sci       Date:  2000-01-21       Impact factor: 5.037

3.  Potential metabolic interaction between St. John's wort and theophylline.

Authors:  A Nebel; B J Schneider; R K Baker; D J Kroll
Journal:  Ann Pharmacother       Date:  1999-04       Impact factor: 3.154

4.  The extent of induction of CYP3A by St. John's wort varies among products and is linked to hyperforin dose.

Authors:  Silke C Mueller; Jolanta Majcher-Peszynska; Bernhard Uehleke; Sebastian Klammt; Ralf G Mundkowski; Wolfram Miekisch; Hartwig Sievers; Steffen Bauer; Bruno Frank; Guenther Kundt; Bernd Drewelow
Journal:  Eur J Clin Pharmacol       Date:  2005-12-10       Impact factor: 2.953

5.  [St. John's wort: a pharmaceutical with potentially dangerous interactions].

Authors:  A E Rätz; M von Moos; J Drewe
Journal:  Praxis (Bern 1994)       Date:  2001-05-10

6.  Equivalence of St John's wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mild-moderate depression.

Authors:  E Schrader
Journal:  Int Clin Psychopharmacol       Date:  2000-03       Impact factor: 1.659

7.  Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding.

Authors:  Patricia A Murphy; Steven E Kern; Frank Z Stanczyk; Carolyn L Westhoff
Journal:  Contraception       Date:  2005-06       Impact factor: 3.375

8.  The interaction between St John's wort and an oral contraceptive.

Authors:  Stephen D Hall; Zaiqi Wang; Shiew-Mei Huang; Mitchell A Hamman; Nina Vasavada; Adegboyega Q Adigun; Janna K Hilligoss; Margaret Miller; J Christopher Gorski
Journal:  Clin Pharmacol Ther       Date:  2003-12       Impact factor: 6.875

9.  Hyperforin content determines the magnitude of the St John's wort-cyclosporine drug interaction.

Authors:  Ingrid Mai; Steffen Bauer; Elke S Perloff; Andreas Johne; Bernhard Uehleke; Bruno Frank; Klemens Budde; Ivar Roots
Journal:  Clin Pharmacol Ther       Date:  2004-10       Impact factor: 6.875

10.  Effect of St John's wort dose and preparations on the pharmacokinetics of digoxin.

Authors:  Silke C Mueller; Bernhard Uehleke; Heike Woehling; Michael Petzsch; Jolanta Majcher-Peszynska; Eva-Maria Hehl; Hartwig Sievers; Bruno Frank; Anne-Kathrin Riethling; Bernd Drewelow
Journal:  Clin Pharmacol Ther       Date:  2004-06       Impact factor: 6.875

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Review 5.  Interactions between herbal medicines and prescribed drugs: an updated systematic review.

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Review 6.  Herb-drug interactions with St John's wort (Hypericum perforatum): an update on clinical observations.

Authors:  Francesca Borrelli; Angelo A Izzo
Journal:  AAPS J       Date:  2009-10-27       Impact factor: 4.009

Review 7.  Cytochrome P450 enzyme mediated herbal drug interactions (Part 1).

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8.  No Clinically Relevant Interactions of St. John's Wort Extract Ze 117 Low in Hyperforin With Cytochrome P450 Enzymes and P-glycoprotein.

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Review 9.  Clinical relevance of St. John's wort drug interactions revisited.

Authors:  Simon Nicolussi; Jürgen Drewe; Veronika Butterweck; Henriette E Meyer Zu Schwabedissen
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