{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:09:03Z","timestamp":1789834143586,"version":"4.0.1"},"reference-count":81,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The general population widely uses herbal medicines, as they are regarded as effective and safe. St. John's wort, which is an effective herbal antidepressant, exhibits both pharmacokinetic and pharmacodynamic interactions with several drugs. The aim of this review was to highlight the clinically significant interactions of St. John's wort with drugs that require to be monitored to assess their therapeutic effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Published literature was searched using electronic databases, such as MEDLINE, PubMed, and Elsevier ScienceDirect using terms such as \u201cherbal medicine,\u201d \u201cherbal toxicity,\u201d \u201clegislation herbal medicine,\u201d \u201cdrug\u2013herb interactions,\u201d \u201cSt. John's wort,\u201d and \u201cSt. John's wort\u2013drug interactions.\u201d Searches were limited to the English language, and there was no restriction on the date of publication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>St. John's wort exhibits a number of pharmacokinetic and pharmacodynamic interactions with drugs. The most dangerous interactions occurred when used concurrently with the immunosuppressants, cyclosporine, and tacrolimus (treatment failure or organ rejection) or warfarin (treatment failure resulting in thromboembolic events) or antiretroviral agents (treatment failure and the emergence of new viral variants that are resistant to conventional drugs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients should consult their health care providers before consuming herbal supplements, especially St. John's wort, to avoid potentially dangerous drug\u2013herb interactions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ftd.0000000000001069","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:48:09Z","timestamp":1673311689000},"page":"35-44","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Utility of Therapeutic Drug Monitoring in Identifying Clinically Significant Interactions Between St. John's Wort and Prescription Drugs"],"prefix":"10.1097","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3575-0410","authenticated-orcid":false,"given":"Vanessa","family":"Steenkamp","sequence":"first","affiliation":[{"name":"Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; 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