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Effects of treatment with a commercially available St John's Wort product (Movina) on cholesterol levels in patients with hypercholesterolemia treated with simvastatin.

Journal article
Authors Robert Eggertsen
Åke Andreasson
Lennart Andrén
Published in Scandinavian journal of primary health care
Volume 25
Issue 3
Pages 154-9
ISSN 0281-3432
Publication year 2007
Published at Institute of Medicine, School of Public Health and Community Medicine
Institute of Medicine, Department of Clinical Trials and Entrepreneurship
Pages 154-9
Language en
Keywords Aged, Anticholesteremic Agents, administration & dosage, therapeutic use, Cholesterol, HDL, blood, Cholesterol, LDL, blood, Drug Therapy, Combination, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, therapeutic use, Hypercholesterolemia, drug therapy, Hypericum, Male, Middle Aged, Phytotherapy, Plant Preparations, administration & dosage, therapeutic use, Simvastatin, administration & dosage, therapeutic use, Tablets, Treatment Outcome, Triglycerides, blood
Subject categories Medical and Health Sciences


OBJECTIVE: To assess the effect of treatment with a St John's Wort product (Movina) on cholesterol levels (total cholesterol, LDL-cholesterol, and HDL-cholesterol) in patients with hypercholesterolemia on treatment with a stable dose of simvastatin. DESIGN: Controlled, randomized, open, crossover pharmacodynamic study. SETTING: Two primary healthcare centres. Intervention. Patients were treated with Movina one tablet (containing 300 mg of Hypericum perforatum) twice daily and control (a commercially available multivitamin tablet, Vitamineral). The trial started with a run-in period of 4 weeks. Then the treatment order between control and active treatment was decided (randomization using sealed envelopes). The duration of each treatment period was 4 weeks and simvastatin treatment was kept unchanged during the whole study period (12 weeks). SUBJECTS: Twenty-four patients with hypercholesterolemia treated with a stable dose of simvastatin (10-40 mg daily) for at least three months. MAIN OUTCOME MEASURES: Assessments of total cholesterol, HDL- cholesterol, LDL-cholesterol, and triglycerides were performed in the morning with the patients in a fasting condition. RESULTS: All patients completed the study. LDL-cholesterol was significantly increased during active treatment compared with control. Thus, the mean LDL-cholesterol after 4 weeks' active treatment was 2.72 mmol/L compared with 2.30 mmol/L after treatment with control (p <0.0001). An increase in total-cholesterol was also observed (5.08 mmol/L compared with 4.56 mmol/L, p <0.0001). CONCLUSION: Products containing St John's Wort should not be given to patients with hypercholesterolemia who are on treatment with simvastatin.

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