Anticancer Agents and St Johns Wort

Clearance of imatinib mesylate, an anticancer drug, is also increased due to administration of St. John's wort resulting in reduced clinical efficacy of the drug. Imatinib is used in the treatment of Philadelphia chromosome positive chronic myeloid leukemia and gastrointestinal stromal tumors. In one study involving 10 healthy volunteers, 2-week treatment with St. John's wort significantly reduced maximum plasma concentration by 29%, AUC by 32. The half-life of the drug was reduced by 21% (47). St. John's wort also showed significant interaction with another anticancer drug irinotecan. In one study involving five patients, ingestion of St. John's wort (900 mg/day) for 18 days resulted in an average 42% reduction in concentration of SN-39, the active metabolite of irinotecan. This reduction also caused decreased myelo-suppression (48).

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