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St. John: Not Such a Saint

Fatal Forty DDI: St. John’s wort, cyclosporine, CYP3A4, P-glycoprotein

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A Case Approach to Perioperative Drug-Drug Interactions

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Abstract

This case discusses the pharmacokinetic interaction between cyclosporine and St. John’s wort, resulting in renal failure. Cyclosporine is a cytochrome P450 3A4 and P-glycoprotein substrate and St. John’s wort is a 3A4 and P-glycoprotein inducer.

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Author information

Authors and Affiliations

  1. Department of Infectious Diseases and Critical Care, Oregon Health and Science University, Portland, OR, USA

    Heather Norvelle PharmD, BCPS

  2. Department Of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA

    Ines P. Koerner MD, PhD

Authors
  1. Heather Norvelle PharmD, BCPS
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  2. Ines P. Koerner MD, PhD
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Corresponding author

Correspondence to Heather Norvelle PharmD, BCPS .

Editor information

Editors and Affiliations

  1. Anesthesia Services Department, Philadelphia Veterans Affairs Med Center, Philadelphia, PA, USA

    Catherine Marcucci MD

  2. Department of Anesthesiology, Oregon Health and Science University, Portland, OR, USA

    Michael P. Hutchens MD

  3. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    Erica D. Wittwer MD, PhD , Toby N. Weingarten MD , Juraj Sprung MD, PhD  & Wayne T. Nicholson MD, PharmD, MSc , ,  & 

  4. Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Kirk Lalwani MD

  5. Department of Anesthesiology, University of Pittsburgh School of Med Liliane S. Kaufmann Building, Pittsburgh, PA, USA

    David G. Metro MD

  6. Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA

    Randal O. Dull MD, PhD

  7. Department of Anesthesiology, Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Christopher E. Swide MD

  8. Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA

    F. Jacob Seagull PhD

  9. Department of Anesthesiology and Perioperative Medicine, Portland, OR, USA

    Jeffrey R. Kirsch MD (Professor and Chair) (Professor and Chair)

  10. Department of Psychiatry, University of Maryland Medical System VA Maryland Health Care System, Baltimore, MD, USA

    Neil B. Sandson MD

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© 2015 Springer Science+Business Media New York

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Norvelle, H., Koerner, I.P. (2015). St. John: Not Such a Saint. In: Marcucci, C., et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7495-1_219

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  • DOI: https://doi.org/10.1007/978-1-4614-7495-1_219

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7494-4

  • Online ISBN: 978-1-4614-7495-1

  • eBook Packages: MedicineMedicine (R0)

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