Oral Contraceptives

Breakthrough bleeding has been reported, which can indicate decreased effectiveness of oral contraceptives. In 2003, a controlled study confirmed that standard doses of SJW cause an induction of ethinyl oestradiol-norethindrone metabolism consistent with increased CYP3A activity (Hall et al 2003) — use this combination with caution.

In 2002, a pharmacokinetic study found no significant interaction between low hyperforin SJW and low-dose oral contraceptives (Madabushi et al 2006) — appears to be safe.

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