| 1. Accepted major perpetrators | 2. Rejected perpetrators | 3. Unclassifiable | 4. Full table |
St. John's wort is a strong inducer of CYP2C19 and CYP3A.
St. John's wort
|Strong inducers||lopinavir/ritonavir  |
St. John's wort 
|carbamazepine  |
St. John's wort 
- Strong inducers: ≥ 2-fold decrease in AUC or ≥ 50% increase in clearance of in vivo CYP probe.
Footnotes and References
|1.||Yeh RF, Gaver VE, Patterson KB, Rezk NL, Baxter-Meheux F, Blake MJ, Eron JJJ, Klein CE, Rublein JC, Kashuba ADM. Lopinavir/Ritonavir Induces the Hepatic Activity of Cytochrome P450 Enzymes CYP2C9, CYP2C19, and CYP1A2 But Inhibits the Hepatic and Intestinal Activity of CYP3A as Measured by a Phenotyping Drug Cocktail in Healthy Volunteers. Journal of Acquired Immune Deficiency Syndromes 2006; 42: 52-60.[PubMed]|
|2.||Haas CE, Brazeau D, Cloen D, Booker BM, Frerichs V, Zaranek C, Frye RF, Kufel T. Cytochrome P-450 mRNA expression in peripheral blood lymphocytes as a predictor of enzyme induction. European Journal of Clinical Pharmacology 2005; 61: 583-93.[PubMed]|
|3.||Wang LS, Zhou G, Zhu B, Wu J, Wang JG, El-Aty AMA, Li T, Liu J, Yang TL, Wang D, Zhong XY, Zhou HH. St John's wort induces both cytochrome P450 3A4-catalyzed sulfoxidation and 2C19-dependent hydroxylation of omeprazole. Clinical Pharmacology & Therapeutics 2004; 75: 191-97.[PubMed]|
|4.||Ucar M, Neuvonen M, Luurila H, Dahlqvist R, Neuvonen PJ, Mjorndal T. Carbamazepine markedly reduces serum concentrations of simvastatin and simvastatin acid. European Journal of Clinical Pharmacology 2004; 59: 879-82.[PubMed]|
|5.||Robertson P, Hellriegel ET, Arora S, Nelson M. Effect of modafinil on the pharmacokinetics of ethinyl estradiol and triazolam in healthy volunteers. Clinical Pharmacology & Therapeutics 2002; 71: 46-56.[PubMed]|
|6.||Backman JT, Olkkola KT, Ojala M, Laaksovirta H, Neuvonen PJ. Concentrations and effects of oral midazolam are greatly reduced in patients treated with carbamazepine or phenytoin. Epilepsia 1996; 37: 253-57.[PubMed]|
|7.||Backman JT, Olkkola KT, Neuvonen PJ. Rifampin drastically reduces plasma concentrations and effects of oral midazolam. Clinical Pharmacology & Therapeutics 1996; 59: 7-13.[PubMed]|
|8.||Wang ZQ, Gorski C, Hamman MA, Huang SM, Lesko LJ, Hall SD. The effects of St John's wort (Hypericum perforatum) on human cytochrome P450 activity. Clinical Pharmacology & Therapeutics 2001; 70: 317-26.[PubMed]|
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