<div style="margin: 12px 0px; font-family: arial; color: #333333; background: #ffffff; border: solid 4px #e5e5e5; width: 100%; clear: left;"><div class="CM_CTB_Content_Wrap" style="margin: 0px; padding: 0px;background-color: #ffffff;"><div style="border-bottom: solid 1px #dcdcdc; white-space: nowrap; margin-bottom: 8px; background-color: #eeeeee ;background-image: url(http://clipmarks.com/images/source-bg.gif); background-repeat: repeat-x; height: 24px; line-height: 24px; vertical-align: middle; padding-bottom: 4px; color: #666666; font-size: 10px;" ><a href="http://clipmarks.com/clip-to-blog/" title="see clips that are hot right now"><img src="http://content.clipmarks.com/blog_embed/8cc2bb6b-c70a-4146-ae3d-1902cbe0335e/C8EF2C1A-BAA0-43A2-9EC8-C679DF46F2BC/" alt="" width="19" height="19" border="0" style="vertical-align: middle; margin: 0px 4px; display: inline; border: none; float:none;" /></a>clipped from <a title="http://64.233.183.104/search?q=cache:k6P3TZTXd4IJ:www.patient.co.uk/showdoc/40025182/+dogs+st+johns+wort+dose&hl=nl&ct=clnk&cd=4&gl=nl&client=firefox-a" href="http://64.233.183.104/search?q=cache:k6P3TZTXd4IJ:www.patient.co.uk/showdoc/40025182/+dogs+st+johns+wort+dose&hl=nl&ct=clnk&cd=4&gl=nl&client=firefox-a" style="font-size: 11px;">64.233.183.104</a></div><blockquote style="text-align: left; padding: 0px 8px; margin: 4px 0px 8px 0px; background: transparent; border: none;" cite="http://64.233.183.104/search?q=cache:k6P3TZTXd4IJ:www.patient.co.uk/showdoc/40025182/+dogs+st+johns+wort+dose&hl=nl&ct=clnk&cd=4&gl=nl&client=firefox-a"><B id="heading" class="boldred">Contraindications</B><UL><li style="margin-left:16px;padding-left: 0px;">It should not be used in pregnancy or lactation, due to lack of evidence of safety.</LI> <li style="margin-left:16px;padding-left: 0px;">It should not be taken at the same time as other <A href="http://www.patient.co.uk/showdoc/40024920/">antidepressants</A>, especially the SSRIs as there is risk of a serotinergic crisis.</LI> <li style="margin-left:16px;padding-left: 0px;">For the same reason it should not be used with the tryptans including sumatriptan, naratriptan, rizatriptan and zolmitriptan</LI> <li style="margin-left:16px;padding-left: 0px;">It should not be used in bipolar disease as it may be associated with mania.<SUP><A href="#ref5">5</A></SUP></LI><li style="margin-left:16px;padding-left: 0px;">Because it induces enzymes associated with cytochrone P450, there are a number of drug interactions with <B>St</B> John's <B>wort</B>.<SUP><A href="#ref6">6</A></SUP> The doctor must decide if these are a contraindication to advising the treatment or if adjustment of doses is required. The following list is by no means exhaustive:<UL><li style="margin-left:16px;padding-left: 0px;">Oral contraceptives</LI> <li style="margin-left:16px;padding-left: 0px;">Warfarin</LI> <li style="margin-left:16px;padding-left: 0px;">Ciclosporin</LI> <li style="margin-left:16px;padding-left: 0px;">Anticonvulsants including <A href="http://www.patient.co.uk/showdoc/40001628/">carbamazepine</A>, phenobarbitone and <A href="http://www.patient.co.uk/showdoc/40001628/">phenytoin</A></LI> <li style="margin-left:16px;padding-left: 0px;">HIV treatments including indinavir, nelfinavir, ritonavir, saquinavir, efavirenz and nevirapine.</LI> <li style="margin-left:16px;padding-left: 0px;">Digoxin</LI> <li style="margin-left:16px;padding-left: 0px;">Theophyllins</LI></UL></LI></UL></blockquote></div><div style="margin: 0px 6px 6px 4px;"><table style="font-size: 11px;border-spacing: 0px;padding: 0px;" cellpadding="0" cellspacing="0" width="100%"><tr><td style="background:transparent;border-width:0px;padding:0px;">&nbsp;</td><td align="right" style="background:transparent;border-width:0px;padding:0px;width:107px" width="107"><a href="http://clipmarks.com/share/C8EF2C1A-BAA0-43A2-9EC8-C679DF46F2BC/blog/" title="blog or email this clip"><img src="http://content7.clipmarks.com/images/c2b-foot.png" border="0" alt="blog it" width="107" height="17" style="border-width:0px;padding:0px;margin:0px;" /></a></td></tr></table></div></div>

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