Recent literature reports regarding drug-drug, herb-drug and food-drug interactions must not be ignored, nor can they always be taken at face value.
Studies have shown that Hypericum perforatum (St. John?s wort) can reduce plasma levels of indinavir, cyclosporin, digoxin, and other possibly other
drugs as well. Current knowledge regarding the metabolism of these medications suggests that the cytochrome P-450 drug metabolizing enzyme sys-tems cannot account for all these effects. The P-glycoprotein (Pgp) trans-membrane pump has been reported to be induced by SJW.
Medications that are substrates of both CYP3A4 and Pgp are of particular concern and may pose special interaction risks with certain foods and
botanical products such as SJW.