Possible Interaction: St John's Wort and Cpt-11

“Co-administered SJW for consecutive 14 days significantly decreased the initial plasma concentration (C0) of CPT-11 , the area under the concentration-time curve (AUC(0-10hr)) and maximum plasma concentration (Cmax) of SN-38.”

“These results indicated that … ethanolic extracts of SJW and its major active components could markedly … SN-38 and intracellular accumulation of CPT-11 and SN-38, which probably provides partial explanation for the altered plasma pharmacokinetics … and SN-38 and the antagonizing effects on the toxicities of CPT-11.”