St. John's Wort Capsules or Tablets

What is this medication?

ST. JOHN'S WORT (seynt JONZ wurt) is promoted for many conditions, such as depression, attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), skin conditions, and symptoms of menopause. This supplement is not intended to diagnose, treat, cure, or prevent any disease.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Bleeding disorders
• Heart disease
• High blood pressure
• HIV or AIDS
• Immune system problems
• Kidney disease
• Liver disease
• Mental illness like anxiety, depression, mania
• Stroke
• Suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
• Taken an MAOI like Carbex, Eldepryl, Marplan, Nardil, or Parnate in last 14 days
• An unusual or allergic reaction to St. John's wort, other herbs, plants, medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth with a glass of water. Follow the directions on the package labeling, or talk to your care team for advice. Take your medication at regular intervals. Do not take your medication more often than directed.

Contact your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Methylene blue (injected into a vein)

This medication may also interact with the following:

• Alcohol
• Amiodarone
• Amphetamines
• Aspirin and aspirin-like medications
• Bosentan
• Certain medications for depression, anxiety, or psychotic disturbances
• Certain medications for migraine headaches like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
• Cyclosporine
• Digoxin
• Female hormones, like estrogens or progestins and birth control pills
• Irinotecan
• Linezolid
• Lithium
• Medications for blood pressure or heart disease
• Medications for HIV infection
• Medications for sleep during surgery
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Procarbazine
• Rasagiline
• Sirolimus
• Sunitinib
• Tacrolimus
• Theophylline
• Tramadol
• Tryptophan
• Warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

If you are already being treated for anxiety, depression, or other mental state use this supplement only by your care team's direction. This supplement my interfere with your other treatments. See your care team if your symptoms do not get better or if they get worse.

This medication can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

If you are scheduled for any medical or dental procedure, tell your care team that you are taking this medication. You may need to stop taking this supplement before the procedure.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your care team if the problem does not go away or is severe.

Herbal or dietary supplements are not regulated like medications. Rigid quality control standards are not required for dietary supplements. The purity and strength of these products can vary. The safety and effect of this dietary supplement for a certain disease or illness is not well known. This product is not intended to diagnose, treat, cure or prevent any disease.

The Food and Drug Administration suggests the following to help consumers protect themselves:

• Always read product labels and follow directions.
• Natural does not mean a product is safe for humans to take.
• Look for products that include USP after the ingredient name. This means that the manufacturer followed the standards of the US Pharmacopoeia.
• Supplements made or sold by a nationally known food or drug company are more likely to be made under tight controls. You can write to the company for more information about how the product was made.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Change in sex drive or performance
• Dizziness
• Dry mouth
• Headache
• Sensitivity to light
• Stomach pain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) or as directed on the package label. Protect from moisture. Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.