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Warning issued against taking St Johns Wort with epilepsy drugs

« H E » email
posted Tuesday, 6 November 2007

The British Medicines and Healthcare products Regulatory Agency has issued a reminder to healthcare professionals that any antiepileptic medicine may interact with St John's wort, and that their concomitant use is therefore not recommended.

The first warnings that some antiepileptic medicines interacted with St John's wort were issued in 2000; these were based on the metabolism of these medicines and the known induction and inhibitory effects of St John's wort on various cytochrome P450 enzymes. The MHRA has continued to receive reports of possible interactions between antiepileptics and St John's wort, including (levetiracetam, lamotrigine, and clobazam which were previously not known to interact.

The Herbal Medicines Advisory Committee and the Commission on Human Medicines Pharmacovigilance Expert Advisory Group have considered the interaction between St John's wort and antiepileptic medicines by routes other than the recognized cytochrome P450 pathway, and both have recommended that the current warnings about interactions should extend to include all antiepileptic medicines including benzodiazepines such as alprazolam (Xanax®), clonazepam (Klonopin®), diazepam (Valium®) and lorazepam (Ativan®).

Additional information...  (PDF format)

tags:  st johns wort  

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