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No interaction between St. John's wort and epilepsy drug

In a study designed to investigate potential interactions between St. John's wort (Hypericum perforatum) and the drug carbamazepine, researchers detected no significant differences in blood concentrations or clearance of the drug before or after administration of St. John's wort. The study involved eight healthy volunteers who took St. John's wort in combination with carbamazepine, an anticonvulsant drug marketed under the trade name Tegretol®. An earlier study conducted by the same research team reported that St. John's wort lowered blood concentrations of indinavir, a protease inhibitor used to treat HIV infection, in healthy volunteers. Like many other drugs, carbamazepine and indinavir are metabolized via the same cytochrome P-450 liver enzyme, CYP3A4. The new study refutes the widespread speculation that St. John's wort lowers blood concentrations of all drugs metabolized via this enzyme system. According to the study authors, up to 7% of people with epilepsy use St. John's wort to improve mood and reduce fatigue. Burstein AH, Horton RL, Dunn T, et al. Lack of effect of St. John's wort on carbamazepine pharmacokinetics in healthy volunteers. Clinical Pharmacology and Therapeutics 2000; 68: 6.

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