St. John's wort, Echinacea interfere with some drugs by moving them out of the body too fast

St. John's wort and Echinacea, two widely-used herbal preparations, have been found to increase activity of a specific enzyme in the liver and intestine, an enzyme involved in the metabolization of roughly one in every four pharmaceutical drugs on the market today, reports a clinical pharmacologist at Indiana University School of Medicine.

Metabolizing pharmaceuticals too slowly or too quickly can cause drug toxicity and/or loss of therapeutic function. Drugs known to be affected range from oral contraceptives to antihypertension medications to drugs to prevent rejection of transplanted organs.

Dr. J. Christopher Gorski described his research and its clinical significance on April 4 at Experimental Biology 2006 in San Francisco. Dr. Gorski was one of several experts speaking at a symposium on metabolic considerations in the action of herbal medicines, part of the scientific program of the American Society for Pharmacology and Experimental Therapeutics.

The fact that St. John's wort causes many drugs to be metabolized too quickly was well established when Dr. Gorski began his research. He wanted to know how it happened. In order to prove that the process involved enzyme cytochrome P450 3A4, he worked with patients who had been taking the herbal preparation before they were given midazolam (Versed), a relaxant often given to patients before minor surgical procedures. Midazolam was chosen because it is one of the pharmaceuticals known to be metabolized by that particular enzyme. Laboratory analysis revealed the relaxant metabolized much more quickly in patients who had been using St. John's wort.

The team then turned to oral contraception, following up on clinical reports that St. John's wort had reduced the efficacy of these drugs. Dr. Gorski found that one or more components of the oral contraceptive were more rapidly metabolized and cleared from the body by cytochrome P450 3A4 in women who also had been taking St. John's w

Contact: Sylvia Wrobel
Federation of American Societies for Experimental Biology

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