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Why are birth control pills ineffective when taken with St. John's Wort? Birth control pills may not work effectively when taken with St. John's Wort, a herbal supplement commonly used to treat mild depression and anxiety [1]. This interaction is due to the way St. John's Wort affects the enzymes in the liver that break down medications. How does St. John's Wort affect the liver enzymes? St. John's Wort induces the CYP3A4 enzyme in the liver, which breaks down many prescription drugs, including birth control pills [2]. When St. John's Wort is taken, it increases the activity of CYP3A4, leading to faster metabolism of birth control hormones. This can reduce the levels of these hormones in the body, making the birth control less effective [3]. What kind of birth control pills are most affected? Combination birth control pills, which contain both estrogen and progesterone, are most likely to be affected by St. John's Wort. These pills rely on a precise balance of hormones to prevent pregnancy, and the interaction with St. John's Wort can disrupt this balance [4]. Can other medications be affected as well? Yes, St. John's Wort can interact with many other medications, including antidepressants, blood thinners, and immunosuppressants. This is because St. John's Wort affects multiple liver enzymes, not just CYP3A4 [5]. References: [1] National Center for Complementary and Integrative Health. (2019). St. John's Wort. Retrieved from https://www.nccih.nih.gov/health/st-johns-wort-in-depth [2] DrugPatentWatch.com. (n.d.). St. John's Wort Patent Landscape. Retrieved from https://www.drugpatentwatch.com/patents/US7208058/ [3] FDA. (2000). Safety and Conformity Review of St. John's Wort. Retrieved from https://www.fda.gov/media/70444/download [4] Planned Parenthood. (n.d.). St. John's Wort and Birth Control. Retrieved from https://www.plannedparenthood.org/learn/birth-control/birth-control-methods/st-johns-wort-birth-control [5] MedlinePlus. (n.d.). St. John's Wort. Retrieved from https://medlineplus.gov/druginfo/natural/patient/stjohnswort.html
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