St. John's wort treatment in women bears risks beyond pharmacokinetic drug interactions.
Nicolas HohmannAnna MausAlexandra CarlsWalter E HaefeliGerd MikusPublished in: Archives of toxicology (2015)
We analyzed adverse events in a clinical phase I trial to assess dose-dependent metabolic effects of St. John's wort co-administered with rifampicin in 12 healthy volunteers. Within 3-6 days after increasing the St. John's wort dose from 300 to 600 mg TID, five of six female participants developed ambient temperature-dependent allodynia and paresthesia in sun-exposed areas (back of the hands and perioral and nasal area). Aggravation of symptoms resulted in persistence of paresthesia and phototoxic erythrodermia. None of the male participants showed any of these effects. Gender, duration of treatment, dose, and solar exposure seem to be extrinsic and host factors facilitating St. John's wort-induced neuropathy. The risk to develop this adverse effect is almost exclusively present in women.
Keyphrases
- polycystic ovary syndrome
- mycobacterium tuberculosis
- clinical trial
- air pollution
- mental health
- pregnancy outcomes
- type diabetes
- pregnant women
- study protocol
- particulate matter
- emergency department
- risk assessment
- metabolic syndrome
- spinal cord injury
- cervical cancer screening
- neuropathic pain
- oxidative stress
- smoking cessation
- stress induced