PI Perspective 29: NIH Study Cautions Use of St. Johns Wort with Anti-HIV Drugs

Important note: Information in this article was accurate in April 2000. The state of the art may have changed since the publication date.

NIH Study Cautions Use of St. Johns Wort with Anti-HIV Drugs

Project Inform Perspectives 29 - April, 2000

A study conducted by the National Institutes of Health (NIH) found a significant interaction between the popular herbal therapy, St John's Wort (Hypericum perforatum), and the protease inhibitor, indinavir (Crixivan). Indinavir blood levels were substantially decreased when the two drugs were used together, greatly reducing indinavir's anti-HIV activity. This can quickly lead to the development of resistance to indinavir. Individuals commonly use St. Johns Wort as a mild anti-depressant.

St. John's Wort is also likely to significantly decrease blood levels of some other protease inhibitors as well as non-nucleoside reverse transcriptase inhibitors. People who take these drugs are advised not to use St. Johns Wort. Similar problems with drug interactions may occur between St. John's Wort and medications used to treat other life-threatening illnesses, such as heart disease.

One possible limitation of the current finding is that it is not clear how it applies to the various forms of St. John's Wort on the market. Because they are completely unregulated, there is no way of knowing how much St. John's Wort is actually present, or the quality of the product. Other preparations may have a stronger or weaker effect. Also, the methodology of the study has not been fully described yet.

As this study illustrates, there's a definite potential for some herbal and nutritional supplements to lower the effectiveness of anti-HIV drugs or other medications. Individuals who use complementary therapies should always discuss possible interactions with their doctors and pharmacists.

000401
PI000406

©2000. This document is copyrighted by Project Inform, 205 13th Street, #2001, San Francisco, CA 94103. Treatment Hotline: 800-822-7422 (toll-free) or 415-558-9051 (in the San Francisco Bay Area and internationally) All Project Inform materials may be reprinted and/or distributed without prior permission. However, reprints may not be edited and must include the following text: "From Project Inform, for more information contact the Project Inform National HIV/AIDS Treatment Hotline, 800-822-7422." For permission to edit any Project Inform material for further publication, contact David Evans at the Project Inform office.

AEGiS is made possible through unrestricted grants from Roxane Laboratories, Inc., iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 1988. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1985, 2000. AEGiS & the Sisters of Saint Elizabeth of Hungary. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS and the Sisters of Saint. Elizabeth of Hungary, or the party credited as the provider of the content.