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What is St Johns Wort (Hypericum perforatum)
St. John’s wort, Hypericum perforatum, is an aromatic perennial native to Europe, parts of Africa and Asia, and the western US. Its yellow flowers are especially bright on June 24, the traditional birthday of St. John the Baptist, hence the name “St. John’s wort”.
Other names include “goat weed” or “klamath weed”. The leaves and flowering tops of Hypericum perforatum yield about 0.1% hypericin, pseudohypericin, and related naphthodianthrones. Flavonoids such as amentoflavone, luteolin, kaempferol, and quercetin and the glycosides hyperoside and rutinoside have also been identified in the plant.
St. John’s wort is widely used in Europe for treatment of depression, dysthymia, and sleep disturbances. The German Commission E has recognized St. John’s wort as a “modestly effective” antidepressant.
Indications
- burns
- depression
Side Effects
- abdominal pain
- anxiety
- cataracts
- dizziness
- drowsiness
- dysesthesia
- dyspepsia
- ejaculation dysfunction
- headache
- increased urinary frequency
- infertility
- insomnia
- mania
- orgasm dysfunction
- peripheral neuropathy
- photosensitivity
- restlessness
- serotonin syndrome
- urticaria
- withdrawal
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- acquired immunodeficiency syndrome (AIDS)
- anticoagulant therapy
- breast-feeding
- cardiac disease
- cerebrovascular disease
- children
- depression
- hepatic disease
- human immunodeficiency virus (HIV) infection
- hypertension
- infertility
- mania
- MAOI therapy
- neonates
- neurological disease
- organ transplant
- pregnancy
- psychosis
- renal disease
- renal impairment
- suicidal ideation
- sunlight (UV) exposure
- surgery
- thyroid disease
Interactions
- Abacavir; Dolutegravir; Lamivudine
- Abemaciclib
- Abiraterone
- Acalabrutinib
- Acetaminophen
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Diphenhydramine
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Acitretin
- Acrivastine; Pseudoephedrine
- Afatinib
- Alfentanil
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Alosetron
- Alpelisib
- Alprazolam
- Aminolevulinic Acid
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine; Dextroamphetamine Salts
- Amprenavir
- Apixaban
- Apremilast
- Aprepitant, Fosaprepitant
- Aripiprazole
- Artemether; Lumefantrine
- Articaine; Epinephrine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atorvastatin
- Atorvastatin; Ezetimibe
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Avapritinib
- Avatrombopag
- Axitinib
- Bedaquiline
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Bepridil
- Betrixaban
- Bexarotene
- Bicalutamide
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Boceprevir
- Bortezomib
- Bosentan
- Bosutinib
- Brentuximab vedotin
- Brexpiprazole
- Brigatinib
- Brivaracetam
- Bromocriptine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Budesonide
- Budesonide; Formoterol
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Cabozantinib
- Caffeine
- Caffeine; Ergotamine
- Cannabidiol
- Capmatinib
- Carbamazepine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Cariprazine
- Carisoprodol
- Ceritinib
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Cilostazol
- Cinacalcet
- Ciprofloxacin
- Cisapride
- Clarithromycin
- Clindamycin
- Clomipramine
- Clonazepam
- Clorazepate
- Clozapine
- Cobicistat
- Cobimetinib
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Conjugated Estrogens
- Conjugated Estrogens; Bazedoxifene
- Conjugated Estrogens; Medroxyprogesterone
- Copanlisib
- Crizotinib
- Cyclophosphamide
- Cyclosporine
- Dabigatran
- Daclatasvir
- Dapsone
- Darolutamide
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Deflazacort
- Delavirdine
- Desipramine
- Desloratadine; Pseudoephedrine
- Desvenlafaxine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexlansoprazole
- Dexmethylphenidate
- Dextromethorphan
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazepam
- Dienogest; Estradiol valerate
- Diethylpropion
- Diethylstilbestrol, DES
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diltiazem
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Phenylephrine
- Disopyramide
- Dobutamine
- Docetaxel
- Dofetilide
- Dolutegravir
- Dolutegravir; Lamivudine
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Dopamine
- Doravirine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxepin
- Doxercalciferol
- Doxorubicin
- Dronabinol
- Dronedarone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Duloxetine
- Duvelisib
- Edoxaban
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Elvitegravir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir alafenamide
- Enalapril; Felodipine
- Encorafenib
- Enflurane
- Entrectinib
- Enzalutamide
- Ephedrine
- Epinephrine
- Eplerenone
- Eravacycline
- Erdafitinib
- Erlotinib
- Esomeprazole
- Esomeprazole; Naproxen
- Estazolam
- Esterified Estrogens
- Esterified Estrogens; Methyltestosterone
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Estradiol; Progesterone
- Estrogens
- Estropipate
- Eszopiclone
- Ethanol
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Etomidate
- Etravirine
- Everolimus
- Exemestane
- Ezetimibe; Simvastatin
- Fedratinib
- Felodipine
- Fentanyl
- Fexofenadine
- Fexofenadine; Pseudoephedrine
- Flibanserin
- Fluoxetine; Olanzapine
- Flurazepam
- food
- Fosamprenavir
- Fospropofol
- Fostamatinib
- Galantamine
- Gefitinib
- Gemifloxacin
- Gilteritinib
- Glasdegib
- Glecaprevir; Pibrentasvir
- Green Tea
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Guanfacine
- Halobetasol; Tazarotene
- Haloperidol
- Halothane
- Homatropine; Hydrocodone
- Hydantoins
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibrutinib
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Idelalisib
- Ifosfamide
- Imatinib
- Imipramine
- Indinavir
- Iobenguane I 131
- Irinotecan
- Irinotecan Liposomal
- Isavuconazonium
- Isoflurane
- Isoproterenol
- Isotretinoin
- Isradipine
- Istradefylline
- Itraconazole
- Ivabradine
- Ivacaftor
- Ivosidenib
- Ixabepilone
- Ixazomib
- Ketamine
- Ketoconazole
- Lansoprazole
- Lansoprazole; Naproxen
- Lapatinib
- Larotrectinib
- Lasmiditan
- Ledipasvir; Sofosbuvir
- Lefamulin
- Lemborexant
- Lesinurad
- Lesinurad; Allopurinol
- Letermovir
- Levofloxacin
- Levomethadyl
- Levomilnacipran
- Lidocaine
- Linagliptin
- Linagliptin; Metformin
- Linezolid
- Lisdexamfetamine
- Lithium
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Loratadine; Pseudoephedrine
- Lorcaserin
- Lorlatinib
- Losartan
- Lovastatin
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lumateperone
- Lurasidone
- Macimorelin
- Macitentan
- Maraviroc
- Mefloquine
- Meperidine
- Meperidine; Promethazine
- Mestranol; Norethindrone
- Metformin; Repaglinide
- Methadone
- Methamphetamine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methohexital
- Methoxsalen
- Methylene Blue
- Methylphenidate
- Midazolam
- Midodrine
- Midostaurin
- Mifepristone
- Milnacipran
- Mirtazapine
- Modafinil
- Monoamine oxidase inhibitors
- Montelukast
- Morphine
- Morphine; Naltrexone
- Moxifloxacin
- Naldemedine
- Naloxegol
- Naproxen; Pseudoephedrine
- Nateglinide
- Nefazodone
- Nelfinavir
- Neratinib
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Niacin; Simvastatin
- Nicardipine
- Nifedipine
- Nilotinib
- Nimodipine
- Nintedanib
- Nisoldipine
- Norepinephrine
- Norfloxacin
- Nortriptyline
- Ofloxacin
- Olanzapine
- Olaparib
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Ondansetron
- Osilodrostat
- Osimertinib
- Ospemifene
- Oxcarbazepine
- Oxybutynin
- Oxycodone
- Ozanimod
- Palbociclib
- Paliperidone
- Panobinostat
- Pantoprazole
- Paricalcitol
- Pazopanib
- Pemigatinib
- Pemoline
- Perampanel
- Perindopril; Amlodipine
- Perphenazine; Amitriptyline
- Pexidartinib
- Phendimetrazine
- Phenothiazines
- Phentermine
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Photosensitizing agents (topical)
- Pimavanserin
- Pitolisant
- Polatuzumab Vedotin
- Pomalidomide
- Ponatinib
- Porfimer
- Posaconazole
- Praziquantel
- Prilocaine; Epinephrine
- Progestins
- Propafenone
- Propofol
- Protease inhibitors
- Proton pump inhibitors
- Protriptyline
- Pseudoephedrine
- Quazepam
- Quetiapine
- Quinidine
- Quinine
- Rabeprazole
- Ranolazine
- Rasagiline
- Red Yeast Rice
- Regorafenib
- Remdesivir
- Remifentanil
- Repaglinide
- Ribociclib
- Ribociclib; Letrozole
- Rilpivirine
- Riluzole
- Rimegepant
- Riociguat
- Ripretinib
- Ritodrine
- Ritonavir
- Rivaroxaban
- Roflumilast
- Rolapitant
- Romidepsin
- Ruxolitinib
- Safinamide
- Saquinavir
- Segesterone Acetate; Ethinyl Estradiol
- Selective serotonin reuptake inhibitors
- Selpercatinib
- Selumetinib
- Serotonin norepinephrine reuptake inhibitors
- Serotonin-Receptor Agonists
- Sevoflurane
- Sibutramine
- Simeprevir
- Simvastatin
- Simvastatin; Sitagliptin
- Siponimod
- Sirolimus
- Sodium Hyaluronate, Hyaluronic Acid
- Sodium Oxybate
- Sofosbuvir
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sonidegib
- Sorafenib
- Sufentanil
- Sunitinib
- Suvorexant
- Tacrine
- Tacrolimus
- Tadalafil
- Tamoxifen
- Tasimelteon
- Tazarotene
- Tazemetostat
- Tedizolid
- Telaprevir
- Telithromycin
- Telotristat Ethyl
- Temsirolimus
- Teniposide
- Tenofovir Alafenamide
- Tenofovir Alafenamide
- Terbinafine
- Testosterone
- Tetracyclines
- Tezacaftor; Ivacaftor
- Theophylline, Aminophylline
- Thiopental
- Thiotepa
- Tiagabine
- Ticagrelor
- Tipranavir
- Tofacitinib
- Tolbutamide
- Tolvaptan
- Toremifene
- Trabectedin
- Tramadol
- Trandolapril; Verapamil
- Trazodone
- Tretinoin, ATRA
- Triazolam
- Tricyclic antidepressants
- Trimipramine
- Tucatinib
- Ubrogepant
- Ulipristal
- Upadacitinib
- Valbenazine
- Vandetanib
- Vemurafenib
- Venetoclax
- Venlafaxine
- Verapamil
- Verteporfin
- Vilazodone
- Vinblastine
- Vincristine
- Vincristine Liposomal
- Vitamin A
- Vorapaxar
- Voriconazole
- Vortioxetine
- Voxelotor
- Warfarin
- Zaleplon
- Zanubrutinib
- Zileuton
- Zolpidem
- Zonisamide