St. John's wort

St. John's wort is an herb that is also known by several other names including Amber, Barbe de Saint-Jean, Chasse-diable, Demon Chaser, Fuga Daemonum, Goatweed, Hardhay, Herbe à la Brûlure, Herbe à Mille Trous, Herbe Aux Fées, Herbe Aux Mille Vertus, Herbe Aux Piqûres, Herbe de Saint Éloi, Herbe de la Saint-Jean, Herbe du Charpentier, Herbe Percée, Hierba de San Juan, Hypereikon, Hyperici Herba, Hypericum perforatum, Klamath Weed, Millepertuis, Millepertuis Perforé, Rosin Rose, Saynt Johannes Wort, SJW, or Tipton Weed.

St. John's wort has been used in alternative medicine as a likely effective help for mild to moderate depression and related symptoms like anxiety or insomnia.

St. John's wort has been used in alternative medicine as a possibly effective help for somatization disorder (physical illness or symptoms without a known cause) or hot flashes from menopause. Topical forms of St. John's wort have been possibly effective in healing skin wounds or treating skin irritation from psoriasis.

St. John's wort has also been used for attention deficit hyperactivity disorder (ADHD), social anxiety, hepatitis C, irritable bowel syndrome, diabetic nerve pain, or burning mouth syndrome. However, research has found that St. John's wort may not be effective for these conditions.

Other uses that are not proven by research include anxiety disorder, obsessive compulsive disorder (OCD), premenstrual syndrome (PMS), seasonal affective disorder (SAD), genital herpes or cold sores, sciatic nerve pain, fibromyalgia, chronic fatigue syndrome, migraine headaches, weight loss, or smoking cessation.

It is not clear whether St. John's wort is effective for any medical condition. The FDA has not approved the medicinal use of this product. St. John's wort should not be used instead of medication prescribed by your doctor.

St. John's wort is commonly sold as an herbal supplement. There are no regulated manufacturing standards for many herbal products, and some supplements on the market have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be bought from a trustworthy source to reduce the risk of contamination.

St. John's wort may also be used for purposes not mentioned in this product guide.

When thinking about using herbal supplements, talk to your doctor. You might also want to consult someone who is trained in herbal or health supplements.

If you decide to use St. John's wort, follow the instructions on the package or those given by your doctor, pharmacist, or other healthcare provider. Do not take more of this product than what is recommended on the label.

Do not use different forms (tablets, capsules, liquid, tincture, teas, etc.) of St. John's wort at the same time without medical advice. Using different types together increases the risk of an overdose.

Take St. John's wort in the morning if it makes it hard for you to sleep.

Do not take topical (for the skin) St. John's wort by mouth. Topical forms of this product are only for use on the skin.

St. John's wort may increase your risk of serious heart problems or other issues during surgery. If you need surgery, stop taking St. John's wort at least 2 weeks beforehand.

Call your doctor if the condition you are treating with St. John's wort does not get better, or if it worsens while you are using this product.

Store at room temperature away from moisture, heat, and light. Being exposed to light can make St. John's wort inactive.

Many medicines can interact with St. John's wort, and serious interactions can happen when certain drugs are taken together. Do not take St. John's wort without consulting your doctor if you regularly use other medicines.

Avoid sunlight while taking St. John's wort. This product can increase your risk of sunburn.

Many drugs can interact with St. John's wort, and serious drug interactions can happen when certain medicines are taken together. Do not take St. John's wort without medical advice if you regularly use other medicines, especially:

• an antidepressant or anti-anxiety medicine;
• asthma or allergy medicine;
• cough or cold medicine;
• cancer medicine (chemotherapy);
• cholesterol medication;
• erectile dysfunction medications;
• heart or blood pressure medicine;
• HIV or AIDS medications;
• medicine to prevent organ transplant rejection;
• medicine to treat any type of infection (including HIV, fungal infections, malaria, or tuberculosis);
• medicine to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders;
• medicine to treat a psychiatric disorder;
• migraine headache medicine;
• seizure medication;
• a steroid; or
• ulcer medicine, or stomach acid reducers to treat heartburn or gastroesophageal reflux disease (GERD).

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have:

• severe depression, or bipolar disorder (manic depression);
• schizophrenia or other mental illness;
• Alzheimer's dementia; or
• attention deficit hyperactivity disorder, especially if you take methylphenidate (Ritalin).

St. John's wort may harm an unborn baby. Do not use this product without medical advice if you are pregnant.

St. John's wort can make birth control pills less effective. Ask your doctor about using non-hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy.

St. John's wort may affect fertility (your ability to have children). You should not use this product if you are trying to get pregnant.

St. John's wort may pass into breast milk and may cause unwanted effects in a nursing baby. Do not use this product without medical advice if you are breastfeeding a baby.

St. John's wort should not be given to a child younger than 6 years old. St. John's wort is thought to be possibly safe for children ages 6 to 17 years old when taken for up to 8 weeks.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Although not all side effects are known, St. John's wort is thought to be likely safe when taken by an adult for up to 12 weeks, or by a child age 6-17 for up to 8 weeks. St. John's wort may be unsafe when taken in large doses.

Stop using St. John's wort and call your healthcare provider at once if you have:

• severe skin rash or irritation;
• severe sunburn (redness, burning, blistering) after being outdoors; or
• (if you are also taking an antidepressant or narcotic pain medicine) -- agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.

Common side effects of St. John's wort may include:

• sleep problems (insomnia), strange dreams;
• feeling anxious, irritable, or restless;
• dry mouth, upset stomach, diarrhea;
• skin rash, tingly feeling;
• headache, dizziness; or
• tired feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra St. John's wort to replace the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Do not take St. John's wort together with other herbal/health supplements without medical advice.

Avoid exposure to sunlight or tanning beds. St. John's wort can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Avoid taking St. John's wort with other medicines that can make you more sensitive to sunlight, especially antibiotic medicine or a sulfa drug.

Many drugs can interact with St. John's wort, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and Herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with St. John's wort. Give a list of all your medicines to any healthcare provider who treats you.