European Journal of Clinical Pharmacology

, Volume 75, Issue 10, pp 1467–1468 | Cite as

No effects of Hypericum-containing complex on dolutegravir plasma trough concentrations: a case report

  • Dario CattaneoEmail author
  • Marta Fusi
  • Cristina Gervasoni
Letter to the Editor

Hypericum perforatum is an herbal product that is commonly used in the treatment of depression [1]. Its antidepressant effect is mediated by hyperforin, a phytochemical which inhibits the reuptake of several neurotransmitters in the synapses [2]. Beside the antidepressant activity, Hypericum can cause relevant drug-drug interactions (DDIs) [3, 4].

Dolutegravir is a key component of first-line treatments for naïve and experienced HIV-infected patients [5]. According to the drug monograph, co-administration of dolutegravir with Hypericum-containing supplements is strongly discouraged. If such combination cannot be avoided, dose of dolutegravir should be doubled [6]. However, such recommendation is predicted based on the inductive effect of this supplement on metabolic enzymes, and pharmacokinetic data are lacking.

A 42-year-old man was diagnosed HIV-positive in 2007. After the diagnosis, the antiretroviral therapy was deferred up to December 2015, when CD4+ cell count dropped to less...


Contribution of the authors

DC and CG supervised all the stages of the study and wrote the first draft of the manuscript. MF performed pharmacokinetic analyses and revised the draft manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Gestione Ambulatoriale Politerapie (GAP) outpatient clinicASST Fatebenefratelli Sacco University HospitalMilanItaly
  2. 2.Unit of Clinical PharmacologyASST Fatebenefratelli Sacco University HospitalMilanItaly
  3. 3.Department of Infectious DiseasesASST Fatebenefratelli Sacco University HospitalMilanItaly

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