Table 4.
Hypericum perforatum L.- ACD interactions among selected ICSRs.
| Drug | Target | Hypericum perforatum L. | Clinic | |||||
|---|---|---|---|---|---|---|---|---|
| DCI/ID/Indication | Level confidence‡† | Mechanism [ref] | Enz/transp/organ | Mechanism [ref] | Herb metabolites | Effect | Concordance with ISCR conclusion | Level of risk |
| OACD Drug | ||||||||
| Everolimus/HP1 /Myelodysplastic syndrome | SmPC | Subst9 | CYP3A4/Pgp | CYP3A4 ind & Pgp inh4 | Hyperforin | PK: ↓ drug blood level | ** | E-4 |
| Nilotinib/HP2/ hronic myeloid leukemia | SmPC | Subst9 | CYP3A4 | CYP3A4 ind4 | Hyperforin | PK: ↓ drug blood level | ** | E-4 |
| PACD Drug | ||||||||
| Temozolomide/HP3/Unknown | SmPC | Photosensitivity58 | cutaneous | Photosensitvity58 | Hypericin | PD: Radiation induced optic neuropathy | ** | D-3 |
OACD: Oral Anti-Cancer Drug; PACD: Parenteral Anti-Cancer Drug; PD: pharmacodynamic; PK: pharmacokinetic; Pgp: P-glycoprotein; CYP3A4: Cytochrome P 450 isoform3A4; Subst: Substrate; Inh: Inhibitor; Ind: Inducer; n.k.: not known; Enz: enzyme; Transp: Transporter; ‡SmPC: Summary of product Characteristics. "Scoring" for the significance of the indicators "*", "**".