Effects of Hypericum perforatum (St John's wort) on the pharmacokinetics and pharmacodynamics of rivaroxaban in humans.

Irene ScholzEvangelia Liakoni Felix Hammann Katharina Elisabeth Grafinger Urs DuthalerMichael NaglerStephan KrähenbühlManuel Haschke

Published in: British journal of clinical pharmacology (2020)

The CYP3A4/P-gp inducing H. perforatum extract caused a decrease of rivaroxaban exposure with a proportional decrease of the pharmacodynamic effect. Although the data do not justify a contraindication for the combination or a systematic adjustment of rivaroxaban dosage, avoidance of the combination or laboratory monitoring should be considered in patients taking hyperforin-containing H. perforatum extracts with rivaroxaban.

Keyphrases

venous thromboembolism
atrial fibrillation
pulmonary embolism
end stage renal disease
ejection fraction
newly diagnosed
chronic kidney disease
peritoneal dialysis
oxidative stress
electronic health record
patient reported outcomes
machine learning
anti inflammatory