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pubmed-article:11849198pubmed:abstractTextSt John's Wort (SJW) is widely used in the treatment of depression but concerns have been raised about its potential to interact with other drugs. Co-administration with SJW has resulted in significant reductions in trough plasma concentrations of indinavir and cyclosporin [1, 2]. Induction of cytochrome P450 3A4 (CYP3A4) has been implicated as the most likely interaction mechanism. However, the magnitude of the interaction seen in clinical practice is greater than that predicted by in vitro studies suggesting additional interaction mechanisms may exist. As indinavir and cyclosporin are substrates for both CYP3A4 and the multi drug transporter P-glycoprotein we hypothesized that modulation of P-glycoprotein expression and function by SJW may contribute to the development of potentially harmful drug-drug interactions.lld:pubmed
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pubmed-article:11849198pubmed:articleTitleSt Johns wort increases expression of P-glycoprotein: implications for drug interactions.lld:pubmed
pubmed-article:11849198pubmed:affiliationDepartment of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Trinity College, Dublin 8, Ireland, UK.lld:pubmed
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