Every viewer of this content, especially those on prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement, product or lifestyle changes. St. John’s Wort. Strongest minimum inhibitory concentrations (MICs) (200 to 250 mcg/mL) were observed against Enterococcus faecium, Staphylococcus aureus, and Staphylococcus epidermidis by H. humifusum extract and against C. albicans by H. perforatum extract. It was noted for its wound-healing and diuretic properties, as well as for the treatment of neuralgic conditions such as back pain. The most frequently described adverse reactions in clinical trials were GI complaints (eg, dry mouth, nausea, change in bowel habits), itching, rash, photosensitization, fatigue, dizziness, confusion, jitteriness, restlessness, insomnia, sedation, sleep disorders, and headache, most of which are attributed to hypericin and pseudohypericin content.Knüppel 2004, Qaseem 2016, Russo 2014, Schulz 2006, Stevinson 1999 Induction of mania has been associated with St. John's wort.Moses 2000, Nierenberg 1999 The volatile oil of St. John's wort is an irritant.Newall 1996 A case report also associated use of St. John's wort with hyponatremia that resulted from syndrome of inappropriate secretion of antidiuretic hormone (SIADH), which has been reported with all classes of synthetic antidepressants.Jones 2014 The contribution of St. John's wort consumption could not be ruled out in a case of development of an extremely rare form of hepatocellular carcinoma in a patient with chronic alcoholism.Lampri 2014, One case report describes acute neuropathy after sun exposure in a patient using St. John's wort.Bove 1998 When ingested, hypericin can induce photosensitization characterized by inflammation of the skin and mucous membranes (including human keratinocytes and lens epithelial cells) following exposure to light, which generates reactive oxidative species that damage axonal membranes directly and activates a calcium-ion channel (transient receptor potential cation channel A1, TRPA1) expressed on peripheral sensory neurons. Avoid combination.Natazia May 2010, Digoxin: St. John's wort may decrease the serum concentration of digoxin. Avoid combination.Samsca February 2012, Shoaf 2012, Trabectedin: St. John's wort may decrease the serum concentration of trabectedin. This information relates to an herbal, vitamin, mineral or other dietary supplement. Last updated on Sep 21, 2020. Consider therapy modification.Russo 2014, Idelalisib: St. John's wort may decrease the serum concentration of idelalisib. With this in mind, consumers need to carefully consider their sources when shopping. Avoid combination.Epclusa June 2016, Mogalian 2016, Venetoclax: CYP3A4 inducers (moderate) may decrease the serum concentration of venetoclax. The American Psychiatric Association practice guideline for the treatment of patients with MDD recognizes that while modest evidence supports the use of St. John's wort, data are conflicting and insufficient to make a recommendation for its use in the treatment of MDD. This isn’t to say you should never step outside again, but laying out for hours at a time probably wouldn’t be a good idea. Avoid combination.Biktarvy February 2018, Boceprevir: St. John's wort may decrease the serum concentration and AUC of boceprevir. In this study, the UV-protective effect of the St. John’s wort cream was tested on 20 volunteers in a randomized, double-blind, vehicle-controlled study. Experts suggest wearing a sunscreen with a minimum 15 SPF. Avoid combination.Inlyta January 2012, Pithavala 2010, Bedaquiline: CYP3A4 inducers (moderate) may decrease the serum concentration of bedaquiline. Clinical trials evaluating the efficacy of St. John's wort in depression have commonly used 900 mg of extract daily in 3 divided doses for periods of up to 12 weeks (range, 200 to 1,800 mg/day).Kasper 2008, Linde 2000, Papakostas 2007, Two studies used a topical hypericum cream containing hypericin 1% and 1.5%.Arndt 2013, Tardivo 2012, The use of St. John's wort in perinatal depression has been considered; however, insufficient data exist to support its use.Freeman 2009 There is a lack of systematic evidence on the safety of Hypericum in pregnancy or lactation.Dugoua 2006, Freeman 2009 A small study of case-matched infants born to mothers consuming St. John's wort during pregnancy found an increase in colic, drowsiness, and lethargy.Dugoua 2006, Studies in rats suggest the preparation may have teratogenic and toxic effects,Gregoretti 2004, Lee 2003, Russo 2014 while other studies suggest no changes in cognitive development or long-term behavior.Dugoua 2006 Emmenagogue and abortifacient effects due to uterine stimulant action have been suggested,Brinker 1998, Ernst 2002, Rotblatt 2002, Shipochliev 1981 but evidence is weak.Dugoua 2006, In 2 separate studies, the rates of major postnatal malformations (eg, hypospadias, bilateral hip dislocation, heart septum defect, obstructed ureter) in children of women exposed to St. John's wort while pregnant were 5% and 8.1%. Monitor therapy.Diamicron July 2016, Xu 2008, Glucocorticoids (oral): St. John's wort may decrease the serum concentration of glucocorticoids (oral). The leaves and flowers of St Johns Wort contain special glands that release a red oil when pinched. St. John’s wort may increase the risk of photosensitivity. Topical application of St. John’s Wort has shown to hydrate skin with it’s natural oils. Saint johns wort, when used externally, will provide protection against the sun, as well as relieve sunburns. Avoid combination.Dresser 2003, Ibrance February 2016, Imai 2008, Sugimoto 2001, Wang 2001, Paliperidone: St. John's wort may decrease the serum concentration of paliperidone. It’s important to discuss taking St. John’s Wort with your doctor as it can impact the effectiveness of some prescriptions such as antidepressants, birth control pills and cancer medications. Avoid combination.Ixempra May 2010, Ketamine (oral): St. John's wort may decrease the serum concentration of ketamine (oral). Monitor therapy.Russo 2014, Grazoprevir: St. John's wort may decrease the serum concentration of grazoprevir. The development of serotonin syndrome may occur. St. John’s Wort oil to treat burns: St. John’s Wort oil soothes the pain caused by burns and accelerates the healing process. Avoid combination.Cometriq December 2012, Canagliflozin: St. John's wort may decrease the serum concentration of canagliflozin.Invokana May 2014, Cannabis: St. John's wort may decrease the serum concentration of cannabis.Sativex February 2014, Watanabe 2007, Cardiac glycosides: St. John's wort may decrease the serum concentration of cardiac glycosides. First, you need to infuse your carrier oil with arnica and St. John’s Wort. It also has mild diuretic properties that can eliminate extra water from the body. St John's Wort (Hypericum perforatum) Oil - 100% Pure & Natural Cold Pressed Infused Oil, Best Vulnerary Oil for Wounds, Burns and Anti-Inflammatory - All Skin Types Aromatherapy 4.0 out of 5 stars33 £2.82£2.82(£282.00/l) Avoid combination.Kisqali March 2017, Rivaroxaban: St. John's wort may decrease the serum concentration of rivaroxaban. The St. John’s Wort plant originated in Europe where it grew wild as a woody shrub. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. St. John’s Wort influences many hormones, but it’s primarily known to help regulate common female hormones as well as stress hormones. This combination is contraindicated in boceprevir prescribing information but was determined to be clinically insignificant in a phase 1, open-label trial (N=17).Jackson 2014, Victrelis May 2011, In healthy adults, coadministration of St. John's wort and boceprevir reduced the steady-state AUC of boceprevir by 9% and increased hypericin AUC by 23%, Cmax by 32%, and C8 by 37%. Zolpidem: St. John's wort may decrease the serum concentration of zolpidem. It’s especially effective in decreasing levels of cortisol (aka the “stress” hormone). As for its other components, interleukins are an important part of the immune system, helping to fight off viruses and other invaders. Insulin disposition indices suggest that St. John's wort reduces glucose-stimulated insulin secretion during the oral glucose tolerance test.Stage 2016, Limited information on genotoxicity exists. With all of these elements combined, it’s easy to see how St. John’s Wort can be such a potent mood booster. St John's wort may decrease the serum concentration of artemether. Organic St John’s Wort Beeswax Dry Skin Cream- Deep Cleansing Herbal Salve Treatment For … Avoid combination.Alacare March 2015, Ameluz May 2016, Drucker 2011, Gleolan June 2017, Ladner 2001, Lankerani 2004, Levulan March 2010, Naldi 1999, Aminolevulinic acid (topical): Photosensitizing agents may enhance the photosensitizing effect of aminolevulinic acid (topical). St. John's wort may decrease the serum concentration of carisoprodol. Topical and internal use of St. John's wort has been reported to provide effective wound healing. It generally reaches a height of 0.3 to 0.61 m, except on the Pacific coast where it has attained heights of 1.5 m.Awang 1991 The plant has oval-shaped leaves and yields golden-yellow flowers that bloom from June to September. Gender differences in the dermal expression of interleukins may be involved in this differential response.Hohmann 2016 An interaction of constituents, as found in the whole plant, has been shown to reduce the toxicity of hypericum extracts.Hammer 2014, Long-term treatment (up to 21 days) with St. John's wort significantly increased 2-hour plasma glucose levels (by approximately 40%), total glucose AUC (by 18%), and incremental blood glucose AUC (by 48%) in 10 healthy men. Monitor therapy.Chang 1997, Ifex March 2012, Kerbusch 2001, Imatinib: St. John's wort may increase the metabolism of imatinib. Avoid combination.Eliquis December 2012, Artemether: St. John's wort may decrease serum concentrations of the active metabolite(s) of artemether. Interventions included H. perforatum as monotherapy (3 studies) as well as in combination with chaste tree or black cohosh. St. John’s Wort For Urinary Incontinence Widely used in the treatment of depression, St John’s Wort eases contractions of the bladder and, therefore, helps with incontinence. Benefit in reducing some climacteric symptoms in women with natural menopause has also been demonstrated. Monitor therapy.Chopra 2004, Duggal 2005, Fisher 2002, Gambassi 2006, Karki 2003, Kaufman 2006, Kim 2007, Kohen 2007, Kontaxakis 2003, Kontaxakis 2003, Marlowe 2006, Matsumoto 2005, Stevens 2008, Verre 2008, Apixaban: St. John's wort may decrease the serum concentration of apixaban. In more recent years, scientific research has supported use of Hypericum for other nervous system complaints, such as anxiety and depression. Meta-analyses of quality clinical trials support a place for St. John's wort in the treatment of depression as mono- or adjunctive therapy. Hypericum perforatum, commonly known as St John's wort, has been used for centuries to treat nerve damage, sciatica and back pain. Avoid combination.Xalkori August 2011, Cyclosporine (systemic): St. John's wort may decrease the serum concentration of cyclosporine (systemic); cases of organ rejection have been documented. This is only a brief summary of general information about this product. Monitor therapy.Arold 2005, Johne 1999, Mueller 2004, Docetaxel: St. John's wort may increase clearance and decrease AUC. Fairly easy to care for, it’s a common favorite among backyard gardeners. St. John's wort is a dietary supplement people often take as a natural treatment for depression. Avoid combination.Afinitor October 2010, Zortress March 2010, Exemestane: St. John's wort may decrease the serum concentration of exemestane. From its mood-boosting ability to its healing advantage, St. John’s Wort benefits are far too numerous and powerful to be overlooked. With all of these elements combined, it’s easy to see how St. John’s Wort can be such a potent mood booster. Avoid combination.Latuda January 2017, Macimorelin: St. John's wort may decrease the serum concentration of macimorelin. Consider therapy modification.Tradjenta May 2011, Linezolid: Linezolid may enhance the serotonergic effect of serotonin modulators. Avoid combination.de Jong 2015, de Zwart 2016, Imbruvica August 2017, Ibuprofen: St. John's wort may decrease the serum concentration of ibuprofen. Autonomic response to physical stimuli was also significantly improved (P<0.01), but not to psychological stressors. After 3 months, median severity score had improved significantly from 24 (±5.1) at baseline to 4.1 (±1) (P<0.0001). Avoid combination.Aptivus October 2007, Tolbutamide: St John's wort may increase the hypoglycemic effects of tolbutamide. Avoid combination.Michelucci 1996, Sular March 2014, Olaparib: CYP3A4 inducers (moderate) may decrease the serum concentration of olaparib. Topical St. John's wort preparations such as oils or tinctures are used for the treatment of minor wounds and burns, sunburns, abrasio … Monitor therapy.Chrubasik-Hausmann 2018, Markowitz 2000, Markowitz 2003, Bictegravir: St. John's wort may decrease the serum concentration of bictegravir. Available for Android and iOS devices. All 17 patients who reported at least a 70% improvement in symptom severity scores and improved sleep during the 10-day induction phase opted to enter the 3-month continuation phase. Minor Burns. CYP3A4 inducers (moderate) may decrease the serum concentration of clarithromycin. Learn more here: We also added it to our Tea Tree Cream so you can experience the benefits all day long. St. John's wort should be avoided during pregnancy and lactation until further long-term studies demonstrate a lack of toxicity in the developing fetus and breastfeeding infants. Avoid combination.Harvoni November 2015, Sovaldi December 2013, Sonidegib: CYP3A4 inducers (moderate) may decrease the serum concentration of sonidegib. Hormones play a large rolling in what causes acne. Consider therapy modification.Russo 2014, Dienogest: St. John's wort may decrease the serum concentration of dienogest. Specifically 5 of 6 females, but 0 of 6 males, developed dermatologic and neurologic symptoms on sun-exposed areas of the back of the hands and perioral and nasal areas within 6 days of increasing the dose of St. John's wort from 300 mg to 600 mg (3 times daily). FREE SHIPPING ON ALL DOMESTIC ORDERS OVER $25! Use daily on face, neck, and body. Avoid combination.Sunvepra March 2016, Atazanavir: St. John's wort may decrease the serum concentration of atazanavir. Subsequently, AST and ALT levels were also decreased. Avoid combination.Tanaka 2011, Tasigna October 2017, NiMODipine: St. John's wort may decrease the serum concentration of nimodipine. Avoid combination.Nexium June 2011, Wang 2004, Estriol (systemic): CYP3A4 inducers (moderate) may decrease the serum concentration of estriol (systemic). Patients ranged in age from 7 to 77 years and presented with HSV-1, HSV-2, or combination-type lesions.Tardivo 2012, The cytocidal activity of hyperforin and its effect on tumor growth inhibition have been demonstrated against human cell lines.Business Wire 1998, Hostanska 2003, Lorusso 2009, Schmitt 2006, Stavropoulos 2006, Platelet response improved significantly subsequent to administration of St. John's wort versus placebo in clopidogrel nonresponders with stable angina who underwent elective percutaneous coronary intervention (PCI). Two meta-analyses evaluating data on SSRIs as a group included 12 randomized controlled trials (RCTs) (N=1,806)Asher 2017 and 27 RCTs (N=3,808), repsectively.Ng 2017 Overall, the strength of evidence was considered low by one paper because of the moderate to low doses of comparator antidepressants used in the studies.Asher 2017, Further studies have shown St. John's wort to be effective in the acute treatment of mild depression at a range of dosages (600 to 1,200 mg daily),Kasper 2008 while long-term studies describe clinical advantage over placebo with regard to time to relapse and overall relapse rates when St. John's wort 900 mg daily was administered over 26 and 52 weeks.Brattström 2009, Kasper 2008 Unintended drug-herb interactions with St. John's wort may compromise the efficacy of other drugs; however, St John's wort as adjunctive therapy has been used clinically to reduce the dose needed for pharmaceutical antidepressants.Izzo 2016, Ravindran 2016 Additionally, as in clinical trials with pharmaceutical antidepressants, a significant placebo effect and similar placebo response pattern occurs in MDD trials with St. John's wort, such that nonresponders will likely exhibit no clinical response early in the trial (ie, within the first 4 weeks) and placebo responders will experience a clinical response within the first 2 weeks of the trial.Sarris 2013, Guidelines discussing the use of St. John's wort in MDD have been published. Additionally, bioactivities of some compounds were dependent on light, whereas others were light independent. Induction of both the intestinal and hepatic CYP3A4 has been observed.Arold 2005, Kummer 2016, Markert 2015, Pereira 2013 Studies with voriconazole indicate that St. John's wort may be a stronger inducer of CYP2C19 and CYP2C9 than CYP3A4. Avoid combination.Cotellic November 2015, Codeine: CYP3A4 inducers (moderate) may decrease serum concentrations of the active metabolite(s) of codeine. Select one or more newsletters to continue. Consider therapy modification.Aromasin March 2011, Flibanserin: CYP3A4 inducers (moderate) may decrease the serum concentration of flibanserin. Avoid combination.Russo 2014, Esomeprazole: St. John's wort may decrease the serum concentration of esomeprazole. Of the 118 cigarette smokers enrolled in the 12-week study, 43% withdrew before study end and were smoking during their last study visit.Sood 2010 Differences in study populations, dosing, and formulation of preparations make comparisons difficult. Monitor therapy.Actiq June 2012, Duragesic April 2014, Kharasch 2004, Morii 2007, Takane 2005, Fexofenadine: St. John's wort taken for several days may decrease the serum concentration of Fexofenadine. It was named after St. John the Baptist as the flower bloomed around his birthday. One study reports that tannin content in extracts is influenced by parameters such as temperature of maceration.Rafajlovska 1998 Phenol constituents include caffeic, chlorogenic, and p-coumaric acids, and hyperfolin. Mix equal parts of St. John’s wort flowers, arnica tincture, witch hazel bark, and chamomile flowers well. Avoid combination.Zykadia April 2014, Clarithromycin: CYP3A4 inducers (moderate) may increase serum concentrations of the active metabolite(s) of clarithromycin. St. John's wort (Hypericum perforatum) is a flowering shrub native to Europe. St. John’s wort may cause anxiety, headache, muscle cramps, sweating, weakness, dry mouth, or skin irritation 32). Look for only the highest quality of St. John’s Wort in order to reap the greatest benefit for your mind and body. This helps to soothe the pain of digestive spasms and menstrual cramps as well as to ease spasmodic coughing. Platelet response improved significantly when measured as P2Y12 reaction units to clopidogrel but not when measured as thrombin receptor activating peptide units to thrombin receptor activating peptide or as aspirin reaction units or arachidonic acid units to aspirin, which indicated a selective interaction of St. John's wort with the clopidogrel pathway.Trana 2013, A case of reduced hyperbilirubinemia, decreased fatigue, and improved quality of life has been reported in a patient with congenital Crigler-Najjar syndrome type II. Penetration of the blood-brain barrier is similarly low with only about 5% of hypericin likely to reach the brain; hypericin's half-life in the brain appears to be a few weeks.Russo 2014 Time to peak plasma levels (Cmax) ranges from 30 minutes to 3 hours for pseudohypericin, from 4.6 to 8.1 hours for hypericin, and about 2.8 to 3.6 hours for hyperforin after single doses of St. John's wort (range, 300 to 1,800 mg [approximately 0.3% of hypericins]).Hammer 2014, Russo 2014 Steady-state levels of hypericin are reached at 4 days, with a prolonged plasma half-life of about 25 hours due to hypericin's high affinity for albumin and lipoprotein. We use it in our Tea Tree Cleanser for it’s ability to cleanse and soothe the skin. Consider therapy modification.Hojo 2011, Izzo 2016, St John's wort interacts significantly with digoxin, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, amiodarone, and warfarin; avoid use in patients with heart failure.Page 2016. ... St. John's wort herbal bath and body oil. Avoid combination.Butterweck 2007, Bosutinib: St. John's wort may decrease the serum concentration of bosutinib. Avoid combination.Ninlaro November 2015, Ixabepilone: St. John's wort may decrease the serum concentration of ixabepilone. Consistent application will firm up the skin, reducing the appearance of fine lines. Avoid combination.Emflaza February 2017, Dextromethorphan: St. John's wort may decrease the serum concentration of dextromethorphan. Cancer is a group of diseases that reflect the cellular change in function, … This could result in serotonin syndrome. This could result in serotonin syndrome. The pleasant scent and versatility make it an ideal, relaxing bath for the entire family. , St. John’s Wort is famous for its depression-reducing qualities. Consider therapy modification.Izzo 2016, Johne 2002, Ulipristal: St. John's wort may decrease the serum concentration of ulipristal. When in creams it help keep open wounds clean by killing microorganisms. It’s especially effective in decreasing levels of cortisol (aka the “stress” hormone). The most commonly described constituents are naphthodianthrones, flavonoids, phloroglucinols, and essential oils. The evidence for St. John's wort suggests that it is not significantly better than placebo for this indication (2 studies, N=261; relative risk [RR], 0.81; 95% CI, 0.26 to 2.53).Hughes 2014 Clinical trials have produced equivocal results regarding a role in smoking cessation, with one small trial (N=24) without a control group showing efficacy in cessation rates with Hypericum at 12 weeksLawvere 2006 and others showing no difference from placebo.Camfield 2013, Parsons 2009, Uzbay 2008 A larger randomized, blinded, placebo-controlled, dose-ranging study similarly found no difference in smoking cessation rates, mean cigarettes smoked per day, withdrawal symptoms, or tobacco cravings in the St. John's wort 900 mg/day or 1,800 mg/day groups compared to placebo. Avoid combination.Sustiva March 2008, Elbasvir: St John's wort may decrease the serum concentration of elbasvir. The flower petals have black or yellow glandular dots and lines. It is an aggressive weed that grows in the dry ground of roadsides, meadows, woods, and hedges. Find St John's Wort coupons, promotions and product reviews on Walgreens.com. A dose-dependent reduction in acetaminophen-induced lethality was also observed.Hohmann 2015, Antibacterial activity has been described.Barbagallo 1987, Bejaoui 2017 Extracts of H. perforatum and Hypericum humifusum containing differing amounts of hypericin (60 mg/g and 90 mg/g, respectively) and hyperforin (8.5 mg/g and 30 mg/g, respectively) exhibited very strong inhibitory and bactericidal activity against several gram-positive and gram-negative bacteria as well as Candida albicans. Hypericin and pseudohypericin inhibit a variety of encapsulated viruses, including HIV.Upton 1997, 3-Hydroxy lauric acid obtained from H. perforatum exhibited light-independent, anti-HIV activity in an in vitro experiment.Maury 2009, Clinical trials of St. John's wort use in HIV are limited by the prevalence of interactions between St. John's wort and standard HIV therapy. However, this multipurpose herb is so much more than a simple blues fighter. Today, it’s been successfully cultivated in other countries, including the United States, Russia and China. Avoid combination.Aptivus April 2011, Crixivan October 2009, Invirase January 2010, Jalloh 2017, Kaletra February 2011, Lexiva September 2009, Norvir November 2009, Piscitelli 2000, Prezista February 2008, Reyataz January 2010, Quetiapine: Quetiapine may enhance the serotonergic effect of St John's wort. We recommend every reader/viewer of our content to consult their doctors or qualified health professionals regarding health questions. Due to the lack of rigorous standardization of product purity and potency in the United States, data were deemed insufficient to recommend a place in therapy for St. John's wort in the treatment of MDD.Qaseem 2016, Based on efficacy in depression, Hypericum extracts have been recommended as appropriate therapy in mild or moderate depression with bipolar disorder as an alternative to standard antidepressant therapy.Andreescu 2008 A trial (N=54) evaluating the efficacy of 900 mg of Hypericum extract daily in adolescents with attention-deficit/hyperactivity disorder and a subsequent systematic review found no difference compared with placebo at 8 weeksSarris 2011, Weber 2008 and no difference using the same dosage in burning mouth syndrome.Sardella 2008 St. John's wort 600 mg/day performed better than placebo in 6 primary outcome measures in patients with somatoform disorders.Müller 2004 Equivocal results have been demonstrated for Hypericum extracts in the management of premenstrual symptoms, which may be reflective of the different dosages used.Hicks 2004, Stevinson 2000 Improvement in total, behavioral, and physical symptoms in women diagnosed with premenstrual syndrome (PMS) has been demonstrated with Hypericum compared to placebo in double-blind RCTs that include a small crossover pilot study (N=36) and a larger prospective trial (N=170).Canning 2010, Ghazanfarpour 2011, Seasonal affective disorder, a type of depression in which symptoms occur in fall/winter and resolve in spring/summer, improved with St. John's wort in combination with light therapy.Martinez 1994 In an open-label trial, statistically but not clinically significant improvements in several target behaviors in 3 young autistic males (19 to 22 years of age) were documented after 4 weeks of St. John's wort 20 mg/day. Bioavailability of these constituents after oral administration is low and ranges from approximately 15% to 20%. Learn more here: If you plan on taking St. John’s Wort in any form, limit your sun exposure as it can make your skin more sensitive to sunlight. St John's Wort (Hypericum Perforatum) Infused Oil Extract (Macerated Oil), 1.7 Oz - 50 Ml/the … Shingles. Avoid combination.Portolés 2006, Procoralan August 2010, Ivacaftor: St. John's wort may decrease the serum concentration of ivacaftor. Contraceptive failure is possible. Consider therapy modification.Russo 2014, Metaxalone: Metaxalone may enhance the serotonergic effect of serotonin modulators. St. John's Wort Cream (2 oz, Zin: 428055) St. John's Wort is an aromatic perennial herb that produces star-shaped golden yellow flower with five petals that secrete a red liquid when pinched. Specifically, meprobamate concentrations may be increased. "Perforatum" refers to the leaf's appearance; when held up to light, the translucent leaf glands resemble perforations.Hahn 1992, Upton 1997 Harvest of the plant for medicinal purposes occurs in July and August, and the plant material must be dried immediately to avoid loss of potency.Bombardelli 1995 The dried herb consists of the plant's flowering tops.Upton 1997, St. John's wort has been used as an herbal remedy for its anti-inflammatory and healing properties since the Middle Ages,Bombardelli 1995 with many herbalists, including Hippocrates and Pliny, recording its medicinal properties.
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