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The BBC's Fergus Walsh reports
"Around two million people in the UK take St Johns Wort"
 real 28k

Prof Alistair Breckenridge
"Patients should consult their doctors"
 real 28k

Wednesday, 1 March, 2000, 12:12 GMT
St John's Wort warning
St John's Wort
St John's Wort may cause medical problems
Women using the contraceptive pill and patients on HIV, depression and migraine treatments have been advised to stop using St John's Wort.

The herbal remedy, used to treat mild depression, has been found to interfere with some prescription medicines, triggering the new guidance from the government.

The consequences may be severe in some patients

Professor Alasdair Breckenridge, chairman, Committee on Safety of Medicines

Other patients should see their doctor for advice about stopping as doing so will affect concentration of medicines in their bodies.

These include people using warfarin and digoxin for blood clots, cylcosporin after heart transplants, and theophylline for severe asthma and chronic bronchitis.

The advice, from the Medicines Control Agency (MCA), follows a report into the herbal remedy, thought to be used by around two million people in the UK, by the independent Committee on Safety of Medicines (CSM).

Click here to see the government's advice in full

Studies published in the Lancet and the British Medical Journal have shown that St John's Wort speeds up the break down of medicines in the body, leading to lower levels of the drug in blood. It can also interfere with brain chemicals.

Use of the remedy by the public is estimated to be increasing at a rate of 2000% each year.

Doctors report problems

Doctors in the UK have reported 14 cases of interactions, under the "yellow card" reporting scheme for adverse drug reactions, which was extended to cover herbal medicines in 1996.

St John's Wort has also been shown to cause break-through bleeding in some women using the pill - indicating reduced efficacy, though there have been no reported cases of pregnancy as a result.

Professor Alasdair Breckenridge, chairman of the CSM, said: "We have some new evidence of the potential safety hazards of St John's Wort, but only when it is used with other medications.

"The consequences may be severe in some patients."

The idea that natural always means 100% safe is wrong

Michael McIntyre, chairman, European Herbal Practitioners Association

People using any medicine should mention to their doctor or pharmacist when prescribed if they already use St John's Wort. No-one should start using the herbal remedy if on prescribed medicines without seeking medical advice.

Michael McIntyre, chairman of the European Herbal Practitioners Association, said: "The idea that natural always means 100% safe is wrong.

"People should be careful about combining medicines."

The MCA is holding discussions with herbal practitioner organisations and trade associations on the information which should be made available with unlicensed herbal remedies containing St John's Wort, including labelling changes.

The MCA will also be updating the patient information of all the licensed medicines most likely to interact with St John's Wort.

Margaret Peet, managing director of GNC, a major health food retailer, said: "Many prescription drugs interact with one another, and the fact that St John's Wort does so with particular drugs does not mean it loses its benefit to other users."

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See also:

01 Mar 00 |  Health
St John's Wort: the advice
10 Dec 99 |  Health
Herb 'helps ease depression'
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