Sienkiewicz Jacek, Czarnik-Matusewicz Henryk, Wiela-Hojeńska Anna
Uniwersytet Medyczny we Wrocławiu, Katedra i Zakład Farmakologii Klinicznej.
Pol Merkur Lekarski. 2013 Nov;35(209):309-12.
Plant medicines used by patients in self-treatment contain powerfully acting active substances which can be a source of adverse events including interactions with synthetic medicines. Usage of St. John's wort causes high risk of various complications. St. John's wort preparations shouldn't be combined with antidepressants without physician's consultation. Long-term intake of medicines which contain Hypericum perforatum extracts can be a reason of undesirable interactions with isoenzymes CYP3A4, CYP1A2, CYP2C9, CYP2C19 and P-glycoprotein (P-gp) for which St John's wort is a substrate. Compounds present in the St. John's wort, especially hyperforin, increase the activity of cytochrome P450 in the liver and intestinal mucosa as well as P-gp, which can accelerate their elimination from the body, decrease their concentrations and reduce the effect. Effective and safe phytotherapy requires a lot of knowledge about the properties and toxicity of preparations used and accurate monitoring of the consequences of their actions.
患者自我治疗中使用的植物药含有强效活性物质，这些物质可能是不良事件的来源，包括与合成药物的相互作用。使用圣约翰草会导致各种并发症的高风险。未经医生咨询，圣约翰草制剂不应与抗抑郁药联合使用。长期摄入含有贯叶连翘提取物的药物可能会与CYP3A4、CYP1A2、CYP2C9、CYP2C19同工酶和P-糖蛋白（P-gp）发生不良相互作用，而圣约翰草是这些酶的底物。圣约翰草中存在的化合物，尤其是金丝桃素，会增加肝脏和肠黏膜中细胞色素P450以及P-糖蛋白的活性，这会加速它们从体内的清除，降低其浓度并减弱效果。有效且安全的植物疗法需要大量关于所用制剂的特性和毒性的知识，以及对其作用后果的精确监测。
