Re: St 's wort and Glucosamine

[Guest guest]

Annie, I don't know if you're pre or post-op, but if you're pre-op,

be careful about the St 's Wort close to surgery.

I am taking amitryptyline (Elavil) for sleep problems, low dose of 10

mg a night. Have been for about 12 years now, and I don't find I have

any problems with it.

[Guest guest]

--- , since i stopped the Dothiepin two weeks ago i've been

getting really bad headaches and feel lethargic. After reading your

post i decided to go to the doctor's surgery and i was able to get

another supply of them and was told that i'm having withdrawal

symptoms caused by abruptly stopping them!!

I thought St john's wort would be a good idea as they're more natural

but apparently they take six weeks to work. Maybe after my surgery

(which is less than a year!!yippee) i'll try alternative medicine. By

the way how do SJW interact with the surgery? I forgot to ask.

Thanks for your advice, it spurred me into taking some action.

Annie

In orthognathicsurgerysupport@y..., fiddlesticks22000 <no_reply@y...>

wrote:

> Annie, I don't know if you're pre or post-op, but if you're pre-op,

> be careful about the St 's Wort close to surgery.

>

> I am taking amitryptyline (Elavil) for sleep problems, low dose of

10

> mg a night. Have been for about 12 years now, and I don't find I

have

> any problems with it.

>

>

[Guest guest]

Hi Annie,

I don't know the specifics of SJW and surgery, but I was recommended

not to take massive doses of anything pre-surgery, and that even

vitamins were not a particularly good idea. They even said to avoid

garlic (it thins the blood). Below this post is an extract done using

a google search on " St 's Wort " + " drug interactions " . It talks

about HIV drugs, but also other meds that it could affect are listed

near the bottom.

The only thing I took was about 10,000 mg of Vit C a day plus a

single dose of Floradix, which is a liquid iron and B vit supplement.

I did do homeopathic remedies, but these are completely different

from herbal remedies, they are extremely dilute, and only used for

specific purposes. I feel that they successfully minimized the

swelling for me.

Here's also a link for herbs and potential drug interactions:

http://ohioline.osu.edu/hyg-fact/5000/5406.html

And another: http://www.healthcastle.com/herb_drugfood.shtml

I'm glad to have been of some help!

Risk of Drug Interactions With St 's Wort

Jane E. Henney, MD

The FDA has asked health care professionals to caution patients about

the risk of potentially significant interaction between St 's

wort (Hypericum perforatum), an herbal product marketed as a dietary

supplement, and other drugs, including indinavir, a protease

inhibitor (PI) used for HIV infection.

The agency's warning is based on a study conducted by the National

Institutes of Health with eight healthy, HIV-negative volunteers.

Participants received 800 mg of indinavir administered on an empty

stomach every 8 hours for 4 doses, with serial pharmacokinetic

sampling before and after the fourth dose. For the next 14 days,

volunteers took 300 mg of St 's wort (0.3% hypericin) three times

daily with food. On the last day of St 's wort, volunteers again

received took 800 mg of indinavir every four hours for a total of 4

doses, with pharmacokinetic sampling before and for 5 hours serially

after the fourth dose.

In this study, St 's wort decreased the area under the curve

(AUC) of indinavir plasma concentration by a mean (SD) of 57% (19%)

and the extrapolated minimum plasma concentration (Cmin) 8 hours

after dose by a mean (SD) of 81% (16%). (For full study results, see

Lancet. 2000;355;547-548.)

Another report strongly suggests that the herb causes a drop in

plasma levels of cyclosporine after heart transplantation (Lancet.

2000;355;548-549). St 's wort appears to be an inducer of the

metabolic pathway cytochrome P450 and may significantly decrease

blood concentrations of all PIs for HIV, including amprenavir,

indinavir, nelfinavir, ritonavir, and saquinavir. The herbal product

may have a similar effect on the nonnucleoside reverse transcriptase

inhibitors (NNRTIs) delavirdine, efavirenz, and nevirapine, which are

metabolized via the same pathway. Consequently, concomitant use of St

's wort and PIs or NNRTIs is not recommended, because it may

result in suboptimal antiretroviral drug concentrations, leading to

loss of virologic response and development of resistance or class

cross-resistance.

Because many drugs that are used to treat heart disease (such as

digoxin, diltiazem, nifedipine, digitoxin, or -blockers), depression

(such as imipramine, amoxapine, or amitriptyline), seizures (such as

carbamazepine, phenytoin, or phenobarbital), certain cancers (such as

cyclophosphamide, tamoxifen, taxol, or etoposide) or to prevent

transplant rejection (such as cyclosporine, rapamycin, or tacrolimus)

or pregnancy (ethinyl estradiol) are metabolized through this

pathway, health care providers should alert patients about these

potential drug interactions.

Serious adverse events associated with St 's wort–drug

interaction should be reported to the FDA MEDWATCH by telephone at

(800) FDA-1088, fax (800) FDA-0178, or Internet at

http://www.fda.gov/medwatch.

AUTHOR INFORMATION

Jane E. Henney, MD

Commissioner of Food and Drugs