St. John's wort herb

St. John's wort (Hyperici herba) is a pharmacopoeial medicinal plant, that is, officially recognized not only by domestic medicine, but also by the British herbal pharmacopoeia, American Herbal Pharmacopoeia (AHP), European Pharmacopoeia, and the World Health Organization. Only in the West this plant is called differently: St. John's herb.

Indications St. John's wort

Phytotherapy is one of the additional methods of complex treatment of many diseases, and indications for the use of St. John's wort (Hypericum perforatum L.) include:

• chronic fatigue, psycho-emotional instability, mild depression;
• gastrointestinal diseases (gastritis with low acidity, gastroenteritis, colitis, diarrhea, flatulence);
• gallbladder pathologies (biliary dyskinesia, cholestasis, cholecystitis);
• diseases of the bladder, urinary tract and kidneys (cystitis, urethritis, urolithiasis);
• tonsillitis (inflammation of the tonsils), stomatitis (inflammation of the oral mucosa), gingivitis (inflammation of the gums), halitosis (bad breath);
• infected wounds, burns, pyoderma.

The biochemical action of St. John's wort (Hypericum perforatum L.) - psychotropic (antidepressant), antispasmodic, antimicrobial, astringent, regenerating - is provided by the active substances included in its composition (see below - Pharmacodynamics).

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Release form

The form of release of St. John's wort herb varies:

• dry crushed plant material (a mixture of dried flowering tops and other above-ground parts of St. John's wort), packed in cardboard boxes of 50-100 g (for preparing a decoction and infusion);
• powder for making herbal tea, packaged in filter bags (1.5-2 g each);
• dry St. John's wort extract (in various packaging and sizes);
• St. John's wort extract in tablets (Gelarium Hypericum, Deprivit, Deprim, Herbion Hypericum);
• liquid extract of St. John's wort Doppelherz Nervotonic;
• 1% alcohol solution Novoimanin in vials;
• alcohol tincture of St. John's wort (Tinctura Hyperici) in bottles.

Names of the collections: St. John's wort (Hyperici herba). This plant is also included in the composition of multi-component herbal collections: Kidney herbal tea, No. 7 Gastrointestinal herbal tea, Healthy Stomach herbal tea, Fitogastrol gastrointestinal collection, Gastrofit collection, etc.

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Pharmacodynamics

The therapeutic effects of St. John's wort are varied, and the pharmacodynamics of this medicinal plant continues to be studied.

St. John's wort tannins have antibacterial and astringent properties and help with diarrhea, as well as various inflammations in the oropharynx and urinary tract. Flavonoid epigallocatechin is an antioxidant and accelerates tissue regeneration, stabilizing the membranes of cells damaged by inflammatory infections. Rutin (vitamin P) has a strengthening effect on the walls of blood vessels, it also participates in the regulation of bile production (accelerating the synthesis of CYP enzymes).

Infection foci with damage or inflammation of the skin and soft tissues are eliminated by external application of a decoction of St. John's wort, which contains phenolic acids (ferulic, hydroxybenzoic, etc.), terpene compounds of essential oils and other biologically active substances. And the pharmacodynamics of their powerful anti-inflammatory effect is associated with the fact that the inflammatory response pathways are blocked (in the form of arachidonate-5-lipoxygenase and COX-1).

The main psychoactive substances of St. John's wort herb - the flavones hypericin, pseudohypericin, hyperforin and adhyperforin - are prenyl derivatives of phloroglucinol, which provides the color of St. John's wort flowers. When taken internally, these substances essentially correct disturbances in the transmission of impulses by neurons of the central nervous system, blocking the reuptake of neurotransmitters (including serotonin, norepinephrine, dopamine and GABA), MAO (monoamine oxidase), etc.

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Pharmacokinetics

The metabolism of all active substances of St. John's wort is not yet known, but some manufacturers briefly describe the pharmacokinetics. Thus, the pharmacists of the company

KRKA (which produces the St. John's wort tablet extract Herbion Hypericum) indicates that six hours after taking the tablet orally, hypericin is absorbed in the gastrointestinal tract by 80% (and coincides with the peak of its content in the blood plasma), and pseudohypericin is adsorbed by 60%.

Within 25-27 hours, the main psychoactive substances of St. John's wort are 50% transformed, but the metabolites are not named. There is also no data on the elimination of the final substances of metabolism from the body.

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Dosing and administration

Method of application Gelarium Hypericum, Deprivit, Gerbion Hypericum – orally, standard doses of these products are 1 tablet 2-3 times a day (course of administration – 1 month);

Doppelherz Nervotonic is also taken orally - a tablespoon twice a day (after meals), the duration of administration is 14-21 days.

St. John's wort tincture can be taken internally - 30-40 drops twice a day, or can be used to prepare a solution (a teaspoon per 150 ml of water) for gargling with tonsillitis and the oral cavity with inflammation of the mucous membrane, gums, bad breath, after tooth extraction, etc.

Novoimanin is used externally - by wetting dressings for infected wounds and purulent skin ulcers, as well as for washing cavities (in the form of a solution diluted with distilled water).

Decoctions and infusions of dry St. John's wort are used both internally and for rinsing and washing. The standard dose of the herb per glass of boiling water is a tablespoon with a small slide. The decoction is boiled for five minutes and infused in a closed container for 30-40 minutes. It is recommended to drink 2-3 sips several times a day.

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Use St. John's wort during pregnancy

Oral use of decoctions, extracts and tinctures of St. John's wort during pregnancy is strictly prohibited, as this plant helps to reduce estrogen levels.

Contraindications

The list of contraindications for the internal use of St. John's wort is as follows: inflammation of the esophagus, liver and kidney failure, photodermatitis, age under 12 years, severe depressive state and severe mental disorders and illnesses (MDP, schizophrenia, etc.).

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Side effects St. John's wort

Medicinal herbs and preparations based on them give fewer side effects, but they still exist. Side effects of decoctions, infusions, extracts of St. John's wort taken orally may manifest as headache and dizziness; increased blood pressure and swelling of soft tissues; dry mouth, nausea, abdominal pain and diarrhea; loss of appetite, fatigue and anxiety.

St. John's wort sometimes causes increased sensitivity to light (photosensitivity), which can lead to hypersensitivity of the eyes to light and sunburn of the skin.

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Overdose

It should be borne in mind that an overdose of St. John's wort (associated with headache, dizziness and dry mouth) is possible even when consuming herbal tea containing St. John's wort, especially if you drink it frequently.

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Interactions with other drugs

It is especially important when using Hyperici herba as an antidepressant to take into account its interactions with other drugs.

It is not allowed to take any medications based on St. John's wort orally at the same time as antidepressant drugs, drugs to reduce blood clotting, cholesterol levels, antiviral, antibacterial and analgesic drugs.

St. John's wort reduces the effectiveness of drugs used against HIV and transplant rejection, as well as hormonal contraceptives.

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Storage conditions

All forms of St. John's wort herb are released in the usual way: at room temperature, ready-made decoction – at +10-15°C.

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Shelf life

The shelf life of dry herbal infusions is 24 months, and the shelf life of the preparations Gelarium Hypericum, Deprivit, Herbion Hypericum, Doppelherz Nervotonic, Novoimani is 3 years.