Plant Comparison
Bay-leaf willowherb vs Perforate St John’s-wort
A side-by-side comparison of two medicinal plants — every documented constituent, action, use, safety note and cited source, assembled automatically from the Omnia Sana database.
At a glance
Bay-leaf willowherb and Perforate St John’s-wort: they share 5 indicated uses (arthritis / joint pain, infection (general), inflammation (general), …); 2 pharmacological actions in common.
Evidence face-off — shared uses
| Condition | Bay-leaf willowherb | Perforate St John’s-wort | Verdict |
|---|---|---|---|
| Arthritis / joint pain | 1/10 | 1/10 | Comparable evidence |
| Infection (general) | 1/10 | 1/10 | Comparable evidence |
| Inflammation (general) | 1/10 | 1/10 | Comparable evidence |
| Skin irritation | 1/10 | 1/10 | Comparable evidence |
| Wounds | 1/10 | 1/10 | Comparable evidence |
Evidence scores (1–10) are computed from the tier of each cited source. “Comparable” means the two scores are within one point. Follow a score to its detailed sources.
Key Constituents
Characteristic Epilobium polyphenols underlying the anti-inflammatory and prostate activity; a genus review identifies oenothein B as the dominant constituent and likely driver of the antimicrobial, anti-inflammatory, anti-proliferative and antioxidant effects.
Antioxidant constituents.
Sterols associated with benign prostatic hyperplasia support.
Red pigments historically used to standardise extracts; contribute to antiviral activity and are the compounds responsible for photosensitivity risk.
Considered the principal compound behind the antidepressant activity and the main driver of the herb's potent CYP3A4/P-glycoprotein induction and drug-interaction profile.
Antioxidant flavonoids contributing to overall activity.
Pharmacological Actions
Traditional & Indicated Uses
inferred from anti-inflammatory action
inferred from anticancer action
inferred from antimicrobial action
inferred from anti-inflammatory action
Supports lower urinary tract symptoms of benign prostatic hyperplasia (prostate support) - a genus Epilobium review notes traditional BPH use attributed mainly to oenothein B, though clinical evidence is not yet conclusive
inferred from anti-inflammatory action
Antibacterial, including against Escherichia coli (urinary support); Supports lower urinary tract symptoms of benign prostatic hyperplasia (prostate support) - a genus Epilobium review notes traditional BPH use attributed mainly to oenothein B, though clinical evidence is not yet conclusive
Supports lower urinary tract symptoms of benign prostatic hyperplasia (prostate support) - a genus Epilobium review notes traditional BPH use attributed mainly to oenothein B, though clinical evidence is not yet conclusive
inferred from anti-inflammatory action
inferred from antiviral action
inferred from anti-inflammatory action
inferred from sedative action
inferred from anti-inflammatory action
Safety, Cautions & Contraindications
Lower urinary tract / prostate symptoms must be medically assessed first to exclude prostate cancer; willowherb is a supportive measure, not a substitute for diagnosis and treatment.
Well tolerated over three months in clinical use; longer-term safety data are limited.
Significant drug interactions: strongly induces CYP3A4 and P-glycoprotein, reducing plasma levels of many drugs including oral contraceptives, antiretrovirals, cyclosporine, warfarin, and digoxin. May cause photosensitivity (fair-skinned individuals). Do not combine with SSRIs, SNRIs, or MAOIs (serotonin syndrome risk). Avoid in bipolar disorder.
Duke (2002) rates St. John's wort as ++ (raised from earlier editions) and notes antidepressant, antiviral, antibacterial, and wound-healing activities at experimental and clinical levels. Hypericin and hyperforin are identified as key active constituents. Clinical evidence (score 2) confirms antidepressant efficacy in mild-to-moderate depression, and WHO/Commission E provide approval for this indication. Dose: 300 mg standardized extract (0.3% hypericin, 3–5% hyperforin) three times daily. Duke emphasizes the critical drug interaction: St. John's wort is a potent CYP3A4 inducer and can significantly reduce blood levels of many medications including oral contraceptives, cyclosporine, antiretrovirals, and warfarin. Avoid combined use with SSRIs (serotonin syndrome risk) and pharmaceutical antidepressants (Duke, 2002).
External Ids
Botanical Description
Slender, softly hairy perennial herb with narrow, lance-shaped leaves and small, four-petalled, pale pink to lilac flowers with a notched tip, borne singly in the upper leaf axils. After flowering, long, narrow seed pods split to release cottony-tufted seeds, typical of the willowherb genus.[13]
Erect, branching perennial herb with paired, oval leaves dotted with tiny translucent oil glands that look like pinpricks when held to the light (giving the species name 'perforatum'). Bright yellow, five-petalled flowers with numerous stamens and black dots along the petal edges are borne in flat-topped clusters, and release a reddish pigment when crushed.[4]
Habitat
Grows in damp meadows, ditches, streamsides and waste ground on moist soils; native to Europe and temperate Asia.[13]
Grows in grassland, roadsides, woodland clearings and waste ground on well-drained soils; native to Europe, Western Asia and North Africa and widely naturalised elsewhere, including North America and Australia.[4]
Harvesting
The flowering aerial parts are cut in summer while in flower, and dried in a warm, shaded, airy place.[13]
The flowering tops (flower and upper leaf) are cut in summer as the flowers open, around the traditional St John's Day period, and dried quickly in a warm, shaded, airy place to preserve the hypericin and hyperforin content.[4]
Traditional Uses
Small-flowered willowherb, along with related Epilobium species, has a Central European folk tradition as a supportive remedy for lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH) and prostatitis, and as an antimicrobial and anti-inflammatory herb for minor infections; the traditional prostate-support use is attributed mainly to its oenothein B content, though robust clinical evidence remains limited.[13]
St John's wort has a centuries-long European folk reputation as a wound-healing and nerve tonic herb, traditionally used for mild wounds, burns and nerve pain and to lift low mood; this traditional mood-supporting use is now one of the most extensively clinically studied applications of any herbal medicine, with standardised extracts shown comparable to conventional antidepressants for mild-to-moderate depression.[1, 4]
Preparations
Dosage
The EU herbal monograph gives 1.5-2.0 g of the comminuted herb in 250 mL of boiling water as an infusion, twice daily, in adults and elderly; long-term use is possible. Lower urinary tract or prostate symptoms should always be medically assessed first, and the monograph directs that a doctor be consulted if fever, spasms, blood in the urine, painful urination or urinary retention occur. Educational reference only, not a prescription.
Clinical trials for mild-to-moderate depression commonly use around 300 mg of standardised extract three times daily (900 mg/day total); given extensive drug interactions, use should be discussed with a healthcare provider, especially alongside other medicines. Educational reference only, not a prescription.
References
Lookalikes Review
Drug Class Interactions
Not documented
Pairings
Not documented
St John's wort raises serotonin activity and can cause serotonin syndrome when combined with other serotonin-boosting agents; pairing it with another mood-active, serotonergic herb such as saffron may add to this risk.[30]
St John's wort is a strong enzyme inducer and increases serotonin activity; combining it with another antidepressant-type herb such as rhodiola may add to serotonergic effects and unpredictably change how each is handled by the body.[30]
St John's wort speeds up the breakdown of many substances and also raises serotonin activity; pairing it with a sedative herb such as valerian may add to drowsiness and can unpredictably change how each is handled by the body.[30, 31]
St John's wort is a strong enzyme inducer and kava is a liver-metabolised sedative; combining them may add to central-nervous-system effects and alter how kava is processed, so combined use warrants caution.[30, 31]
References & Sources
- Vitalone, A. and Allkanjari, O (2018) 'Epilobium spp: Pharmacology and Phytochemistry', Phytotherapy Research, 32(7), pp. 1229-1240. doi:10.1002/ptr.6072 Traditional / reference
https://doi.org/10.1002/ptr.6072 - Cicero, A.F.G., Allkanjari, O., Busetto, G.M., Cai, T. et al (2019) 'Nutraceutical treatment and prevention of benign prostatic hyperplasia and prostate cancer', Archivio Italiano di Urologia e Andrologia, 91(3), pp. 139-152. doi:10.4081/aiua.2019.3.139 Traditional / reference
https://doi.org/10.4081/aiua.2019.3.139 - Vlase, A.M., Toiu, A., Gligor, O., Muntean, D. et al (2024) 'Investigation of Epilobium hirsutum L. Optimized Extract's Anti-Inflammatory and Antitumor Potential', Plants (Basel), 13(2), pp. 198. doi:10.3390/plants13020198 Preclinical
https://doi.org/10.3390/plants13020198 - Granica, S., Piwowarski, J.P., Czerwinska, M.E. and Kiss, A.K (2014) 'Phytochemistry, pharmacology and traditional uses of different Epilobium species (Onagraceae): a review', Journal of Ethnopharmacology, pp. 316--346. doi:10.1016/j.jep.2014.08.036 Traditional / reference
https://doi.org/10.1016/j.jep.2014.08.036 - Ramstead, A.G., Schepetkin, I.A., Quinn, M.T. and Jutila, M.A (2012) 'Oenothein B, a cyclic dimeric ellagitannin isolated from Epilobium angustifolium, enhances IFN-gamma production by lymphocytes', PLoS One, 7(11), pp. e50546. doi:10.1371/journal.pone.0050546 Preclinical
https://doi.org/10.1371/journal.pone.0050546 - Kiss, A.K., Bazylko, A., Filipek, A., Granica, S., Jaszewska, E., Kiarszys, U., Kosmider, A. and Piwowarski, J (2011) 'Oenothein B's contribution to the anti-inflammatory and antioxidant activity of Epilobium sp', Phytomedicine, 18(7), pp. 557-560. doi:10.1016/j.phymed.2010.10.016 Preclinical
https://doi.org/10.1016/j.phymed.2010.10.016 - Schepetkin, I.A., Kirpotina, L.N., Jakiw, L., Khlebnikov, A.I., Blaskovich, C.L., Jutila, M.A. and Quinn, M.T (2009) 'Immunomodulatory activity of oenothein B isolated from Epilobium angustifolium', Journal of Immunology, 183(10), pp. 6754-6766. doi:10.4049/jimmunol.0901827 Preclinical
https://doi.org/10.4049/jimmunol.0901827 - Ducrey, B., Marston, A., Gohring, S., Hartmann, R.W. and Hostettmann, K (1997) 'Inhibition of 5-alpha-reductase and aromatase by the ellagitannins oenothein A and oenothein B from Epilobium species', Planta Medica, 63(2), pp. 111-114. doi:10.1055/s-2006-957624 Preclinical
https://doi.org/10.1055/s-2006-957624 - Schepetkin, I.A., Ramstead, A.G., Kirpotina, L.N., Voyich, J.M., Jutila, M.A. and Quinn, M.T (2016) 'Therapeutic potential of polyphenols from Epilobium angustifolium (fireweed)', Phytotherapy Research, 30(8), pp. 1287-1297. doi:10.1002/ptr.5648 Meta-analysis / review
https://doi.org/10.1002/ptr.5648 - Merighi, S., Travagli, A., Tedeschi, P., Marchetti, N. and Gessi, S (2021) 'Antioxidant and anti-inflammatory effects of Epilobium parviflorum, Melilotus officinalis and Cardiospermum halicacabum plant extracts in macrophage and microglial cells', Cells, 10(10), pp. 2691. doi:10.3390/cells10102691 Preclinical
https://doi.org/10.3390/cells10102691 - Hevesi Toth, B., Blazics, B. and Kery, A (2009) 'Polyphenol composition and antioxidant capacity of Epilobium species', Journal of Pharmaceutical and Biomedical Analysis, 49(1), pp. 26-31. doi:10.1016/j.jpba.2008.09.047 Preclinical
https://doi.org/10.1016/j.jpba.2008.09.047 - Vitalone, A., McColl, J., Thome, D., Costa, L.G. and Tita, B (2003) 'Characterization of the effect of Epilobium extracts on human cell proliferation', Pharmacology, 69(2), pp. 79-87. doi:10.1159/000072360 Preclinical
https://doi.org/10.1159/000072360 - Steenkamp, V., Gouws, M.C., Gulumian, M., Elgorashi, E.E. and van Staden, J (2005) 'Studies on antibacterial, anti-inflammatory and antioxidant activity of herbal remedies used in the treatment of benign prostatic hyperplasia and prostatitis', Journal of Ethnopharmacology, pp. 2005. doi:10.1016/j.jep.2005.07.007 Traditional / reference
https://doi.org/10.1016/j.jep.2005.07.007 - European Medicines Agency (HMPC) (2015) 'European Union herbal monograph on Epilobium angustifolium L. and/or Epilobium parviflorum Schreb., herba'. Available at: https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-epilobium-angustifolium-l-andor-epilobium-parviflorum-schreb-herba_en.pdf Traditional / reference
https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-epilobium-angustifolium-l-andor-epilobium-parviflorum-schreb-herba_en.pdf - Coulson, S., Rao, A., Beck, S.L., Steels, E., Gramotnev, H. and Vitetta, L (2013) 'A phase II randomised double-blind placebo-controlled clinical trial investigating the efficacy and safety of ProstateEZE Max: a herbal medicine preparation (containing Epilobium parviflorum) for the management of symptoms of benign prostatic hypertrophy', Complementary Therapies in Medicine. doi:10.1016/j.ctim.2013.01.007 Randomized trial
https://doi.org/10.1016/j.ctim.2013.01.007
- Ng, Q.X., Venkatanarayanan, N. and Ho, C.Y.X (2017) 'Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis', Journal of Affective Disorders, 210, pp. 211-221. doi:10.1016/j.jad.2016.12.048 Meta-analysis / review
https://doi.org/10.1016/j.jad.2016.12.048 - Kholghi, G., Arjmandi-Rad, S., Zarrindast, M.R. and Vaseghi, S (2022) 'St. John's wort (Hypericum perforatum) and depression: what happens to the neurotransmitter systems?', Naunyn-Schmiedeberg's Archives of Pharmacology, 395(6), pp. 629-642. doi:10.1007/s00210-022-02229-z Traditional / reference
https://doi.org/10.1007/s00210-022-02229-z - Fugh-Berman, A (2000) 'Herb-drug interactions', Lancet, 355(9198), pp. 134-138. doi:10.1016/S0140-6736(99)06457-0 Traditional / reference
https://doi.org/10.1016/S0140-6736(99)06457-0 - Nobakht, S.Z., Akaberi, M., Mohammadpour, A.H., Tafazoli Moghadam, A. and Emami, S.A (2022) 'Hypericum perforatum: Traditional uses, clinical trials, and drug interactions', Iranian Journal of Basic Medical Sciences, 25(9), pp. 1045-1058. doi:10.22038/IJBMS.2022.65112.14338 Meta-analysis / review
https://doi.org/10.22038/IJBMS.2022.65112.14338 - Jiang, Z., Wang, F., Zhao, Y., Lu, L., Jiang, X., Huang, T., Lin, Y., Guo, L., Weng, Z. and Liu, E (2024) 'Hypericum perforatum L. attenuates depression by regulating Akkermansia muciniphila, tryptophan metabolism and NFkB-NLRP2-Caspase1-IL1beta pathway', Phytomedicine, 132, pp. 155847. doi:10.1016/j.phymed.2024.155847 Preclinical
https://doi.org/10.1016/j.phymed.2024.155847 - Oliveira, A.I., Pinho, C., Sarmento, B. and Dias, A.C.P (2016) 'Neuroprotective Activity of Hypericum perforatum and Its Major Components', Frontiers in Plant Science, 7, pp. 1004. doi:10.3389/fpls.2016.01004 Meta-analysis / review
https://doi.org/10.3389/fpls.2016.01004 - Russo, E., Scicchitano, F., Whalley, B.J., Mazzitello, C., Ciriaco, M., Esposito, S., Patane, M., Upton, R., Pugliese, M., Chimirri, S., Mammi, M., Palleria, C. and De Sarro, G (2013) 'Hypericum perforatum: pharmacokinetic, mechanism of action, tolerability, and clinical drug-drug interactions', Phytotherapy Research, 28(5), pp. 643-655. doi:10.1002/ptr.5050 Meta-analysis / review
https://doi.org/10.1002/ptr.5050 - Saddiqe, Z., Naeem, I. and Maimoona, A (2010) 'A review of the antibacterial activity of Hypericum perforatum L', Journal of Ethnopharmacology, 131(3), pp. 511-521. doi:10.1016/j.jep.2010.07.034 Meta-analysis / review
https://doi.org/10.1016/j.jep.2010.07.034 - Mennini, T. and Gobbi, M (2004) 'The antidepressant mechanism of Hypericum perforatum', Life Sciences, 75(9), pp. 1021-1027. doi:10.1016/j.lfs.2004.04.005 Meta-analysis / review
https://doi.org/10.1016/j.lfs.2004.04.005 - Liu, Y., Jiang, Y., Huang, R., Yang, J., Xiao, B. and Dong, J (2013) 'Hypericum perforatum L. preparations for menopause: a meta-analysis of efficacy and safety', Climacteric, 17(4), pp. 325-335. doi:10.3109/13697137.2013.861814 Meta-analysis / review
https://doi.org/10.3109/13697137.2013.861814 - Wurglics, M. and Schubert-Zsilavecz, M (2006) 'Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients', Clinical Pharmacokinetics, 45(5), pp. 449-468. doi:10.2165/00003088-200645050-00002 Meta-analysis / review
https://doi.org/10.2165/00003088-200645050-00002 - Kasper, S (2001) 'Hypericum perforatum - a review of clinical studies', Pharmacopsychiatry, 34(Suppl 1), pp. S51-S55. doi:10.1055/s-2001-15467 Meta-analysis / review
https://doi.org/10.1055/s-2001-15467 - Nathan, P (1999) 'The experimental and clinical pharmacology of St John's Wort (Hypericum perforatum L.)', Molecular Psychiatry, 4(4), pp. 333-338. doi:10.1038/sj.mp.4000557 Meta-analysis / review
https://doi.org/10.1038/sj.mp.4000557 - Verotta, L (2003) 'Hypericum perforatum, a source of neuroactive lead structures', Current Topics in Medicinal Chemistry, 3(2), pp. 187-201. doi:10.2174/1568026033392589 Meta-analysis / review
https://doi.org/10.2174/1568026033392589 - Linde, K. et al (2008) 'St John'. Traditional / reference
https://scholar.google.com/scholar?q=St%20John - Natural Standard (2013) 'Hypericum perforatum (St'. Traditional / reference
https://scholar.google.com/scholar?q=Hypericum%20perforatum%20%28St - Duke, J.A (2002) 'Handbook of Medicinal Herbs, Second Edition'. Traditional / reference
https://scholar.google.com/scholar?q=Handbook%20of%20Medicinal%20Herbs%2C%20Second%20Edition - Zhou, S., Chan, E., Pan, S.Q., Huang, M. and Lee, E.J.D (2004) 'Pharmacokinetic interactions of drugs with St John's wort', Journal of Psychopharmacology, 18(2), pp. 262-276. doi:10.1177/0269881104042632 Meta-analysis / review
https://doi.org/10.1177/0269881104042632 - Izzo, A.A. and Ernst, E (2009) 'Interactions between herbal medicines and prescribed drugs: an updated systematic review', Drugs, 69(13), pp. 1777-1798. doi:10.2165/11317010-000000000-00000 Meta-analysis / review
https://doi.org/10.2165/11317010-000000000-00000 - Borrelli, F. and Izzo, A.A (2009) 'Herb-drug interactions with St John's wort (Hypericum perforatum): an update on clinical observations', The AAPS Journal, 11(4), pp. 710-727. doi:10.1208/s12248-009-9146-8 Meta-analysis / review
https://doi.org/10.1208/s12248-009-9146-8 - Nicolussi, S., Drewe, J., Butterweck, V. and Meyer zu Schwabedissen, H.E (2020) 'Clinical relevance of St. John's wort drug interactions revisited', British Journal of Pharmacology, 177(6), pp. 1212-1226. doi:10.1111/bph.14936 Meta-analysis / review
https://doi.org/10.1111/bph.14936 - Piscitelli, S.C., Burstein, A.H., Chaitt, D., Alfaro, R.M. and Falloon, J (2000) 'Indinavir concentrations and St John's wort', Lancet, 355(9203), pp. 547-548. doi:10.1016/S0140-6736(99)05712-8 Clinical study
https://doi.org/10.1016/S0140-6736(99)05712-8 - Barone, G.W., Gurley, B.J., Ketel, B.L., Lightfoot, M.L. and Abul-Ezz, S.R (2000) 'Drug interaction between St. John's wort and cyclosporine', Annals of Pharmacotherapy, 34(9), pp. 1013-1016. doi:10.1345/aph.10088 Clinical study
https://doi.org/10.1345/aph.10088 - Murphy, P.A., Kern, S.E., Stanczyk, F.Z. and Westhoff, C.L (2005) 'Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding', Contraception, 71(6), pp. 402-408. doi:10.1016/j.contraception.2004.11.004 Clinical study
https://doi.org/10.1016/j.contraception.2004.11.004 - Murphy, P.A., Kern, S.E., Stanczyk, F.Z. and Westhoff, C.L (2005) 'Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding', Contraception, 71(6), pp. 402-408. doi:10.1016/j.contraception.2004.11.004 Clinical study
https://doi.org/10.1016/j.contraception.2004.11.004 - Pfrunder, A., Schiesser, M., Gerber, S., Haschke, M., Bitzer, J. and Drewe, J (2003) 'Interaction of St John's wort with low-dose oral contraceptive therapy: a randomized controlled trial', British Journal of Clinical Pharmacology, 56(6), pp. 683-690. doi:10.1046/j.1365-2125.2003.02005.x Randomized trial
https://doi.org/10.1046/j.1365-2125.2003.02005.x - Johne, A., Brockmoller, J., Bauer, S., Maurer, A., Langheinrich, M. and Roots, I (1999) 'Pharmacokinetic interaction of digoxin with an herbal extract from St John's wort (Hypericum perforatum)', Clinical Pharmacology and Therapeutics, 66(4), pp. 338-345. doi:10.1053/cp.1999.v66.a101944 Clinical study
https://doi.org/10.1053/cp.1999.v66.a101944 - Mathijssen, R.H.J., Verweij, J., de Bruijn, P., Loos, W.J. and Sparreboom, A (2002) 'Effects of St. John's wort on irinotecan metabolism', Journal of the National Cancer Institute, 94(16), pp. 1247-1249. doi:10.1093/jnci/94.16.1247 Randomized trial
https://doi.org/10.1093/jnci/94.16.1247 - Smith, P., Bullock, J.M., Booker, B.M., Haas, C.E., Berenson, C.S. and Jusko, W.J (2004) 'The influence of St. John's wort on the pharmacokinetics and protein binding of imatinib mesylate', Pharmacotherapy, 24(11), pp. 1508-1514. doi:10.1592/phco.24.16.1508.50958 Clinical study
https://doi.org/10.1592/phco.24.16.1508.50958 - Izzo, A.A (2004) 'Drug interactions with St. John's Wort (Hypericum perforatum): a review of the clinical evidence', International Journal of Clinical Pharmacology and Therapeutics, 42(3), pp. 139-148. doi:10.5414/cpp42139 Meta-analysis / review
https://doi.org/10.5414/cpp42139 - Caus, M.N., Lupoae, M. and Chitescu, C.L (2026) 'Efficacy and Safety of Herbal Supplements with Anxiolytic, Antidepressant, and Sedative Action: A Review of Clinical Data and Toxicological Risks', Pharmaceuticals, 19(3), pp. 399. doi:10.3390/ph19030399 Meta-analysis / review
https://doi.org/10.3390/ph19030399
Generated automatically from the Omnia Sana plant database and its cited sources. For educational purposes only — not medical advice. Always consult a qualified practitioner before using medicinal plants.