Evaluating the Influence of St. John's Wort on Naproxen Pharmacokinetics and Pharmacodynamics: A Drug Interaction Assessment.

Abstract

Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune disease which leads to pain and disability that may trigger anxiety and sleep disturbances. Naproxen and St. John's Wort concomitant administration in RA and anxiety raises the question of safety due to a potential drug interaction.

Materials and methods: Albino Wistar rats were treated with naproxen and St. John's Wort for 30 days. The study involved the evaluation of safety of naproxen when combined with St. John's Wort by estimation of biochemical markers such as SGOT, SGPT, TG's, Creatinine, BUN, the extent of gastromucosal damage and estimation of AUC, t1/2 and Clearance using blood serum analysis with HPLC after 30 days of treatment. Histopathological studies were also conducted to determine the tissue architecture.

Results: Elevated levels of hepatic markers SGOT, SGPT, TG, and gastro-mucosal damage with enhanced ulcer index were found in naproxen-St. John's Wort treated rats as compared to only naproxen treated rats. HPLC analysis displayed increased AUC and t1/2 of naproxen with decreased clearance in naproxen-St. John's Wort treated rats. Histopathological findings revealed tissue rupture and mucosal damage supporting the naproxen toxicity.

Conclusion: Consulting a healthcare professional before combining St. John's Wort with naproxen is essential to assess potential risks, manage drug interactions, and ensure safety. Personalized advice helps optimize treatment outcomes for both rheumatoid arthritis and mental health.