st. john's wort (Hypericum perforatum)-oral (cont.)
DRUG INTERACTIONS: Before using this product, tell your doctor or pharmacist of all prescription and nonprescription medications you may use, especially of: drugs used to treat HIV infection such as protease inhibitors (e.g., indinavir) and nonnucleoside reverse transcriptase inhibitors (NNRTI's such as delavirdine, efavirenz, nevirapine), other drugs which can cause bleeding/bruising (e.g., thrombolytic drugs such as TPA, anticoagulants such as heparin or warfarin, antiplatelet drugs including NSAIDs such as ibuprofen), beta-blockers (e.g., metoprolol, propranolol), digoxin, cyclosporine, cyclophosphamide, tamoxifen, etoposide, paclitaxel, anti-seizure drugs (e.g., carbamazepine, phenytoin), diltiazem, nifedipine, tacrolimus, sirolimus, tricyclic antidepressants (e.g., amitriptyline, nortriptlyline). Low-dose aspirin (usually 81-325 mg per day) for heart attack or stroke prevention should be continued unless your doctor instructs you otherwise. Aspirin is similar to NSAID drugs, and can increase the risk of bleeding in combination with this medication (see above). Discuss the risks and benefits with your doctor. This product may interfere with the effectiveness of certain drugs, including birth control pills. You may need to use other methods of birth control while taking this product. St John's wort may affect the way your liver processes other drugs. Therefore, discuss with your doctor or pharmacist the use of St John's wort in combination with other drugs.
OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.
NOTES: Check product labeling carefully. St John's wort is Hypericum perforatum and should not be confused with other Hypericum species.
MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
STORAGE: Refer to storage information printed on the package. If you have any questions about storage, ask your pharmacist.
Last Editorial Review: 3/2/2005
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