European Journal of Clinical Pharmacology

, Volume 63, Issue 10, pp 913–916 | Cite as

Interaction between a commercially available St. John’s wort product (Movina) and atorvastatin in patients with hypercholesterolemia

Pharmacodynamics

Abstract

Objective

The aim of this study was to assess the effect of treatment with a St. John’s wort product (Movina) on cholesterol [total cholesterol, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol] and triglyceride levels in patients with hypercholesterolemia on treatment with a stable dose of atorvastatin in a controlled, randomised, open, crossover interaction study.

Methods

Sixteen patients with hypercholesterolemia treated with a stable dose of atorvastatin (10–40 mg/daily) for at least 3 months were treated with Movina one tablet (containing 300 mg of hypericum perforatum) twice daily and control (a commercially available multivitamin tablet Vitamineral). After a run-in period of 4 weeks, patients were randomised to treatment with either Movina or control for 4 weeks in a crossover design. The atorvastatin dose was kept unchanged during the study period (12 weeks), and assessments of total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides were performed in the morning with the patients in the fasting condition. The difference between control and active treatment in LDL cholesterol after 4 weeks of treatment was the primary endpoint.

Results

All patients completed the study. The St. John’s wort product significantly increased the serum level of LDL cholesterol compared with control (2.66 mmol/l compared with 2.34 mmol/l, p = 0.004). A significant increase in total cholesterol was also observed (5,10 mmol/l compared with 4.78 mmol/l, p = 0.02). No statistically significant change was observed in HDL cholesterol (1.59 mmol/l and 1.56 mmol/l, p = 0.49) or in triglycerides (1.87 mmol/l and 1.94 mmol/l, p = 0.60). No product-related side effects were reported

Conclusion

An interaction was observed between the studied St.-John’s-wort-containing product and atorvastatin. Physicians and patients should be aware of this interaction and if treatment with a St. John’s wort product is considered necessary, then there may be a need for increasing the dose of atorvastatin.

Keywords

St. John’s wort Hypericum perforatum Atorvastatin Interaction LDL cholesterol 

Notes

Acknowledgements

Financial support for this study was in part received from a research grant from the county of Western Sweden (Västra Götalandsregionen).

Conflict of Interest Statement

The authors of this paper have no conflict of interest to declare.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Department of Medicine/Clinical PharmacologyGothenburg University, Sahlgrenska University HospitalGothenburgSweden
  2. 2.Department of Medicine/Primary Health CareGothenburg UniversityGothenburgSweden

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