At the beginning of March, the Medicines Control Agency (MCA) issued a press release giving a warning on possible contra-indications to consumers using St John´s Wort.

If you are currently taking medicines for transplant operations, heart conditions, blood clots and asthma, you are advised to consult with your doctor or pharmacist before taking St John´s Wort as recent studies have shown that it may interfere with the action of some orthodox medicines.

The report recommends that you stop taking St John´s Wort if you were also taking oral contraceptives, medicines for depression or migraine as this may reduce their effectiveness. Those taking medicine for HIV infection are urged to stop taking the herbal remedy and consult their doctor.

Acting on the advice received from the Committee on Safety of Medicines, the MCA are holding discussion with herbal practitioner and manufacturer organisations to discuss how information on the risks of unlicensed herbal remedies should be made available to the public, including labelling changes. Michael McIntyre, Chairman of the European Herbal Practitioners Association, said "Herbal practitioners are aware that herbal medicines need to be prescribed and taken with care. They fully support the action being taken to inform the public of possible interactions between St John´s Wort and certain other medicines." A spokesman for the Health Food Manufacturers Association also agreed on the importance to keep the public well informed about the need to use St John´s Wort with care and said, "This underlines the need to press ahead in the search to improve regulatory arrangements for herbals."

The MCA is to be commended for its enlightened approach to the difficulties and, unlike the Republic of Ireland, for not banning this herbal remedy which has proved invaluable to many people suffering from depression. A copy of the MCA´s Fact Sheet for the Public has been reproduced for your information on the following page. For the purpose of disseminating the information supplied as widely as possible, we have decided to publish the complete information for the public as given on their Fact Sheet, at the same time, we would endorse the HFMA statement (see front page) of the urgent need to develop an appropriate regulatory framework for all unlicensed herbal remedies: St John´s Wort (Hypericum) products are unlicensed herbal remedies. Their levels of active ingredients can vary from one preparation to another. They are widely used in the UK, being available from pharmacies, health food shops and herbal practitioners. St John´s Wort preparations may interfere (interact) with medicines, stopping them from working properly. If you are taking medicines, it may not be safe for you to take St John´s Wort.

The advice below is given to help you understand how this may affect you.

I am currently taking a St John´s Wort product and I am not taking any medicine(s).
Advice: If you buy a medicine from a pharmacy, or are prescribed a medicine by your doctor, you must tell your pharmacist or doctor about the St John´s Wort product.
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I am already taking medicine(s) but I would like to start taking a St John´s Wort product.
Advice: You must not take a St John´s Wort product until you have checked with your pharmacist or doctor that it is safe for you to do so.
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Epilepsy or fits: I am on tablets for epilepsy/fits and I am also taking a St John´s Wort product, Transplant: I am on tablets following a transplant and I am also taking a St John´s Wort product, Asthma or chronic bronchitis: I am on theophylline tablets for my chest and I am also taking a St John´s Wort product, Blood clots: I am taking warfarin to thin my blood and I am also taking a St John´s Wort product,
Advice for patients with any of these conditions: You will need to stop taking the St John´s Wort product as it may stop your medicine from working properly. However, you should see your pharmacist or doctor before stopping the St John´s Wort product as the dose of your medicine may need to be altered to prevent side effects.
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Contraceptive pill: I am on the pill and I am also taking a St John´s Wort product,
Advice: You should stop taking the St John´s Wort product as it may stop your pill from working. Continue to take your contraceptive pill as normal. There is no need to see your pharmacist or doctor urgently, however, mention it when you next consult your doctor or are dispensed a medicine.
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Migraine: I take treatment for migraine and I am also taking a St John´s Wort product, Depression: I am on treatment for depression and I am also taking a St John´s Wort product,
Advice: You should stop taking the St John´s Wort product as it may stop your medicine from working. There is no need to see your pharmacist or doctor urgently, however, mention it when you next consult your doctor or are dispensed a medicine.
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HIV: I am HIV positive and on treatment and I am also taking a St John´s Wort product,
Advice: You should stop taking the St John´s Wort product and see your doctor who may suggest you have your HIV viral load checked.
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Further advice required: I am currently taking both a St John´s Wort product and a prescribed medicine not mentioned above. Advice: Tell your pharmacist or doctor that you are taking a St John´s Wort product when you are next dispensed a medicine or consult your doctor.