Tags

Type your tag names separated by a space and hit enter

Effects of St. John's wort supplementation on ibuprofen pharmacokinetics.
Ann Pharmacother. 2007 Feb; 41(2):229-34.AP

Abstract

BACKGROUND

St. John's wort is a popular herbal supplement that has been involved in various herb-drug interactions. Experimental findings suggest that the supplement may impact CYP2C9 metabolism. CYP2C9 is responsible for the irreversible metabolism of ibuprofen.

OBJECTIVE

To examine the effect of 3 weeks of St. John's wort administration on the stereoselective pharmacokinetics of ibuprofen.

METHODS

Eight male subjects participated in this study. The single-dose pharmacokinetics of ibuprofen were evaluated before and after 21 days of St. John's wort administration. Plasma ibuprofen concentrations were determined, using a stereoselective, reversed-phase HPLC assay. Model independent methods were used to evaluate the pharmacokinetics of each ibuprofen enantiomer. Data were analyzed by 2 way ANOVA testing and confidence interval testing.

RESULTS

S(+)-ibuprofen mean +/- SD AUC and maximum concentration (C(max)) values were 131.6 +/- 26.8 microg x h/mL and 31.8 +/- 7.33 microg/mL, respectively, for control samples and 122.4 +/- 32.9 microg x h/mL and 33.6 +/- 7.83 microg/mL, respectively, after St. John's wort treatment. R(-)-ibuprofen mean AUC and C(max) values were 85.1 +/- 26.6 microg x h/mL and 28.4 +/- 8.72 microg/mL, respectively, for control samples and 87.7 +/- 30.1 microg x h/mL and 30.0 +/- 8.97 microg/mL, respectively, for St. John's wort treatment samples. St. John's wort administration resulted in no significant effects on the C(max) and AUC of either stereoisomer. A 31% decrease in S(+)-ibuprofen mean residence time (p = 0.02) was observed.

CONCLUSIONS

St. John's wort administration for 21 days had no apparent clinically important impact on the single-dose pharmacokinetic parameters of S(+)- and R(-)-ibuprofen. Although St. John's wort treatment appears to significantly reduce the mean residence time of S-ibuprofen, no ibuprofen dose adjustments appear warranted when the drug is administered orally with St. John's wort, due to the lack of significant change observed in ibuprofen AUC and C(max) for either enantiomer.

Authors+Show Affiliations

College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX 77004, USA. bellec@tsu.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

17284505

Citation

Bell, Edward C., et al. "Effects of St. John's Wort Supplementation On Ibuprofen Pharmacokinetics." The Annals of Pharmacotherapy, vol. 41, no. 2, 2007, pp. 229-34.
Bell EC, Ravis WR, Lloyd KB, et al. Effects of St. John's wort supplementation on ibuprofen pharmacokinetics. Ann Pharmacother. 2007;41(2):229-34.
Bell, E. C., Ravis, W. R., Lloyd, K. B., & Stokes, T. J. (2007). Effects of St. John's wort supplementation on ibuprofen pharmacokinetics. The Annals of Pharmacotherapy, 41(2), 229-34.
Bell EC, et al. Effects of St. John's Wort Supplementation On Ibuprofen Pharmacokinetics. Ann Pharmacother. 2007;41(2):229-34. PubMed PMID: 17284505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of St. John's wort supplementation on ibuprofen pharmacokinetics. AU - Bell,Edward C, AU - Ravis,William R, AU - Lloyd,Kimberly Braxton, AU - Stokes,Thomas J, Y1 - 2007/02/06/ PY - 2007/2/8/pubmed PY - 2007/4/27/medline PY - 2007/2/8/entrez SP - 229 EP - 34 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 41 IS - 2 N2 - BACKGROUND: St. John's wort is a popular herbal supplement that has been involved in various herb-drug interactions. Experimental findings suggest that the supplement may impact CYP2C9 metabolism. CYP2C9 is responsible for the irreversible metabolism of ibuprofen. OBJECTIVE: To examine the effect of 3 weeks of St. John's wort administration on the stereoselective pharmacokinetics of ibuprofen. METHODS: Eight male subjects participated in this study. The single-dose pharmacokinetics of ibuprofen were evaluated before and after 21 days of St. John's wort administration. Plasma ibuprofen concentrations were determined, using a stereoselective, reversed-phase HPLC assay. Model independent methods were used to evaluate the pharmacokinetics of each ibuprofen enantiomer. Data were analyzed by 2 way ANOVA testing and confidence interval testing. RESULTS: S(+)-ibuprofen mean +/- SD AUC and maximum concentration (C(max)) values were 131.6 +/- 26.8 microg x h/mL and 31.8 +/- 7.33 microg/mL, respectively, for control samples and 122.4 +/- 32.9 microg x h/mL and 33.6 +/- 7.83 microg/mL, respectively, after St. John's wort treatment. R(-)-ibuprofen mean AUC and C(max) values were 85.1 +/- 26.6 microg x h/mL and 28.4 +/- 8.72 microg/mL, respectively, for control samples and 87.7 +/- 30.1 microg x h/mL and 30.0 +/- 8.97 microg/mL, respectively, for St. John's wort treatment samples. St. John's wort administration resulted in no significant effects on the C(max) and AUC of either stereoisomer. A 31% decrease in S(+)-ibuprofen mean residence time (p = 0.02) was observed. CONCLUSIONS: St. John's wort administration for 21 days had no apparent clinically important impact on the single-dose pharmacokinetic parameters of S(+)- and R(-)-ibuprofen. Although St. John's wort treatment appears to significantly reduce the mean residence time of S-ibuprofen, no ibuprofen dose adjustments appear warranted when the drug is administered orally with St. John's wort, due to the lack of significant change observed in ibuprofen AUC and C(max) for either enantiomer. SN - 1542-6270 UR - https://www.unboundmedicine.com/medline/citation/17284505/Effects_of_St__John's_wort_supplementation_on_ibuprofen_pharmacokinetics_ L2 - http://journals.sagepub.com/doi/full/10.1345/aph.1H602?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -