What is the half-life and washout period of St. John's Wort (Hypericum perforatum)?

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Last updated: February 15, 2025View editorial policy

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From the Guidelines

The half-life of St. John's Wort (Hypericum perforatum) is not explicitly stated, but its washout period is recommended to be 2 weeks due to its long-acting constituents and potential interactions with other medications 1.

Key Considerations

  • The main pharmacologic effect of St. John's Wort seems to be inhibition of reuptake of serotonin, norepinephrine, and dopamine 1.
  • It is a strong inducer of CYP3A4, which may reduce plasma concentrations of drugs metabolized by this enzyme 1.
  • St. John's Wort may decrease platelet aggregation and increase the risk of serotonin syndrome when combined with other serotonergic agents 1.
  • The recommended washout period of 2 weeks is likely due to the potential for interactions with other medications, such as warfarin, and the risk of perioperative bleeding 1.

Clinical Implications

  • Patients taking St. John's Wort should be advised to stop taking it 2 weeks before surgery or other medical procedures to minimize potential interactions and risks 1.
  • Healthcare providers should be aware of the potential interactions between St. John's Wort and other medications, and monitor patients closely for signs of serotonin syndrome or other adverse effects 1.

From the Research

Half-Life and Washout Period of St. John's Wort

  • There is no direct information available in the provided studies regarding the half-life and washout period of St. John's Wort (Hypericum perforatum) 2, 3, 4, 5, 6.
  • The studies primarily focus on the clinical effects, efficacy, and safety of St. John's Wort in treating depression and other conditions, but do not provide specific details on its pharmacokinetics, such as half-life and washout period.
  • Further research would be necessary to determine the half-life and washout period of St. John's Wort, as this information is not available in the provided evidence 2, 3, 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[St. John's Wort (Hypericum perforatum): a plurivalent raw material for traditional and modern therapies].

Forschende Komplementarmedizin und klassische Naturheilkunde = Research in complementary and natural classical medicine, 2003

Research

St. John's Wort (Hypericum perforatum): clinical effects on depression and other conditions.

Alternative medicine review : a journal of clinical therapeutic, 1998

Research

Long-term effects of St. John's wort (Hypericum perforatum) treatment: a 1-year safety study in mild to moderate depression.

Phytomedicine : international journal of phytotherapy and phytopharmacology, 2009

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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