Skip to main content

Drug Interactions between methyl aminolevulinate topical and st. john's wort

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

St. John's wort methyl aminolevulinate topical

Applies to: st. john's wort and methyl aminolevulinate topical

MONITOR: Concomitant use of aminolevulinate topical preparations with other known photosensitizing agents may enhance the phototoxic reaction to photodynamic therapy. These agents have each been individually associated with photosensitivity reactions and may have additive effects if administered concurrently. Medicinal products with known phototoxic or photoallergic potential include fluoroquinolones, phenothiazines, retinoids, sulfonamides, sulfonylureas, tetracyclines, thiazide diuretics, griseofulvin, and hypericin extracts (e.g., St John's Wort).

MANAGEMENT: Caution is advised and pharmacologic response to photodynamic therapy should be carefully monitored if concomitant use of other photosensitizing agents cannot be avoided. Patients should be advised to avoid exposure of treated areas to sunlight or bright indoor lights (e.g., examination lamps, operating room lamps, tanning beds, lights at close proximity) during the period between application of aminolevulinic acid or methyl aminolevulinate and photoactivation, and for 48 hours post-illumination. As sunscreen is not effective in protecting treated areas of skin, patients should be counseled to wear protective apparel, such as a wide-brimmed hat, long sleeve shirt, and gloves to protect themselves. Concomitant use with other topical medicinal products should be avoided. Some authorities recommend avoiding use of hypericin-containing products for 2 weeks prior to treatment with topical aminolevulinic acid.

References

  1. (2001) "Product Information. Levulan Kerastick (aminolevulinic acid)." Berlex Laboratories
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."
  4. (2008) "Product Information. Metvixia (methyl aminolevulinate topical)." Galderma Laboratories Inc
  5. Hoffman GA, Gradl G, Schulz M, Haidinger G, Tanew A, Weber B (2020) "The frequency of photosensitizing drug dispensings in Austria and Germany: A correlation with their photosensitizing potential based on published literature." J Eur Acad Dermatol Venereol, 34, p. 589-600
  6. Blakely KM, Drucker AM, Rosen CF (2019) "Drug-induced photosensitivity—an update: Culprit drugs, prevention and management." Drug Saf, 42, p. 827-47
  7. (2022) "Product Information. Metvix (methyl aminolevulinate topical)." Galderma (UK) Ltd
  8. (2022) "Product Information. Metvix (methyl aminolevulinate topical)." Galderma Australia Pty Ltd
  9. (2023) "Product Information. Metvix (methyl aminolevulinate topical)." Galderma Canada Inc
  10. (2021) "Product Information. Ameluz (aminolevulinic acid topical)." Biofrontera Inc.
  11. (2006) "Product Information. Levulan Kerastick (aminolevulinic acid topical)." DUSA Pharmaceuticals Inc
  12. (2021) "Product Information. Ameluz (aminolevulinic acid topical)." Biofrontera Pharma GmbH
  13. (2016) "Product Information. Alacare (aminolevulinic acid topical)." Link Medical Products Pty Ltd T/A Link Pharmaceuticals
  14. (2018) "Product Information. Alacare (aminolevulinic acid topical)." medac UK
View all 14 references

Switch to consumer interaction data

Drug and food interactions

Moderate

St. John's wort food

Applies to: st. john's wort

GENERALLY AVOID: An isolated case report suggests that foods containing large amounts of tyramine may precipitate a hypertensive crisis in patients treated with St. John's wort. The mechanism of interaction is unknown, as St. John's wort is not thought to possess monoamine oxidase (MAO) inhibiting activity at concentrations achieved in vivo. The case patient was a 41-year-old man who had been taking St. John's wort for seven days prior to presentation at the emergency room with confusion and disorientation. The patient recalled last eating aged cheese and having a glass of red wine approximately 10 hours prior to admission. No other cause of delirium or hypertension could be identified. In addition, alcohol may potentiate some of the pharmacologic effects of St. John's wort. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Until further information is available, patients treated with St. John's wort should consider avoiding consumption of protein foods in which aging or breakdown of protein is used to increase flavor. These foods include cheese (particularly strong, aged or processed cheeses), sour cream, wine (particularly red wine), champagne, beer, pickled herring, anchovies, caviar, shrimp paste, liver (particularly chicken liver), dry sausage, figs, raisins, bananas, avocados, chocolate, soy sauce, bean curd, yogurt, papaya products, meat tenderizers, fava beans, protein extracts, and dietary supplements. Caffeine may also precipitate hypertensive crisis so its intake should be minimized as well. Patients should also be advised to avoid or limit consumption of alcohol.

References

  1. Patel S, Robinson R, Burk M (2002) "Hypertensive crisis associated with St. John's Wort." Am J Med, 112, p. 507-8

Switch to consumer interaction data

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

Report options

Loading...
QR code containing a link to this page

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer