Plant Comparison

Perforate St John’s-wort vs Common coltsfoot

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.

First plant
Second plant
Show:
Plant APerforate St John’s-wortHypericum perforatumHypericaceaeFull monograph →
Plant BCommon coltsfootTussilago farfaraAsteraceaeFull monograph →

At a glance

Perforate St John’s-wort and Common coltsfoot: they share 4 indicated uses (arthritis / joint pain, inflammation (general), insomnia / sleeplessness, …); 2 pharmacological actions in common.

Perforate St John’s-wortCommon coltsfoot
Constituents33
Pharmacological actions62
Indicated uses94
Safety notes27
Cited sources3115
Indicated uses
Only Perforate St John’s-wort
BruisingCold & fluEczemaInfection (general)Wounds
Shared (4)
Arthritis / joint painInflammation (general)Insomnia / sleeplessnessSkin irritation
Only Common coltsfoot
none
Pharmacological actions
Only Perforate St John’s-wort
AntioxidantAntiviralEmollient / skin-soothingVulnerary (wound healing)
Shared (2)
Anti-inflammatorySedative / sleep support
Only Common coltsfoot
none

Evidence face-off — shared uses

ConditionPerforate St John’s-wortCommon coltsfootVerdict
Arthritis / joint pain1/101/10Comparable evidence
Inflammation (general)1/102/10Comparable evidence
Insomnia / sleeplessness1/101/10Comparable evidence
Skin irritation1/101/10Comparable 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

Naphthodianthrones (hypericin, pseudohypericin)[4]

Red pigments historically used to standardise extracts; contribute to antiviral activity and are the compounds responsible for photosensitivity risk.

Phloroglucinols (hyperforin)[4]

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.

Hyperforin
Flavonoids (hyperoside, quercetin, rutin)[4]

Antioxidant flavonoids contributing to overall activity.

FlavonoidsQuercetinRutin
Pyrrolizidine alkaloids (senkirkine, senecionine-type)[12]

Hepatotoxic constituents that are the central safety concern for this plant; regulatory limits and PA-controlled/PA-reduced products exist specifically because of these compounds.

Alkaloids
Mucilage[1, 2]

Demulcent polysaccharide contributing to the traditional soothing action on irritated airways.

Mucilage
Flavonoids and tannins[1, 2]

Contribute to anti-inflammatory and astringent activity.

FlavonoidsTannins

Pharmacological Actions

Anti-inflammatory[5, 15, 16]
Antioxidant[6, 15, 16]
Antiviral[15, 16]
Emollient / skin-soothing[15, 16]
Sedative / sleep support[1, 2, 4, 5, 9, 11, 12, 13, 14, 15, 16]
Vulnerary (wound healing)[4, 15, 16]
Anti-inflammatory[1, 2, 10, 11, 12]
Sedative / sleep support[2, 11, 12]

Traditional & Indicated Uses

Arthritis / joint pain[15, 16]Traditional · 1/10

inferred from anti-inflammatory action

Evidence: 1
Label: Arthritis / joint pain
Bruising[15, 16]Traditional · 1/10

inferred from vulnerary action

Evidence: 1
Label: Bruising
Cold & flu[15, 16]Traditional · 1/10

inferred from antiviral action

Evidence: 1
Label: Cold & flu
Eczema[15, 16]Traditional · 1/10

inferred from emollient action

Evidence: 1
Label: Eczema
Infection (general)[15, 16]Traditional · 1/10

inferred from antiviral action

Evidence: 1
Label: Infection (general)
Inflammation (general)[15, 16]Traditional · 1/10

inferred from anti-inflammatory action

Evidence: 1
Label: Inflammation (general)
Insomnia / sleeplessness[15, 16]Traditional · 1/10

inferred from sedative action

Evidence: 1
Label: Insomnia / sleeplessness
Skin irritation[15, 16]Traditional · 1/10

inferred from anti-inflammatory action

Evidence: 1
Label: Skin irritation
Wounds[15, 16]Traditional · 1/10

inferred from vulnerary action

Evidence: 1
Label: Wounds
Arthritis / joint pain[2, 11, 12]Traditional · 1/10

inferred from anti-inflammatory action

Evidence: 1
Label: Arthritis / joint pain
Inflammation (general)[2, 10, 11, 12]Traditional · 2/10

inferred from anti-inflammatory action

Evidence: 2
Label: Inflammation (general)
Insomnia / sleeplessness[2, 11, 12]Traditional · 1/10

inferred from sedative action

Evidence: 1
Label: Insomnia / sleeplessness
Skin irritation[2, 11, 12]Traditional · 1/10

inferred from anti-inflammatory action

Evidence: 1
Label: Skin irritation

Safety, Cautions & Contraindications

Safety note[15, 16]Caution

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.

Safety note[15, 16, 17]Caution

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).

Safety note[5, 11, 12, 13]Caution

Safety notes (contraindications, interactions, pregnancy/lactation notes, adverse effects, dose-duration cautions) Important: Coltsfoot naturally contains pyrrolizidine alkaloids (PAs)—plant chemicals that can damage the liver and may increase cancer risk with enough exposure (EMA, 2021; Kopp et al., 2020).

Safety note[5, 11, 12, 13]Info

Because of this, European regulators set very strict limits for PA exposure from herbal products (EMA, 2021).

Safety note[5, 11, 12, 13]Caution

Many safety-focused herbal references recommend avoiding homemade/internal coltsfoot use, unless the product is specifically made to be PA-controlled / PA-reduced (EMA, 2021).

Safety note[5, 11, 12, 13]Caution

Avoid internal use if you are pregnant or breastfeeding, have liver disease, or for children—these groups are treated as “sensitive” in PA risk guidance (EMA, 2021).

Safety note[5, 11, 12, 13]Caution

Medication caution: if you take medicines that stress the liver (some prescription drugs can), it’s extra important to avoid unregulated PA exposure (general PA risk logic; consult a clinician) (EMA, 2021).

Safety note[5, 11, 12, 13]Info

Topical use may still carry PA considerations; EMA discusses limits and recommends use only on intact skin for PA-containing products (EMA, 2021).

Safety note[5, 11, 12, 13, 14]Serious

Duke (2002) provides clinical support (score 2) for coltsfoot's anti-inflammatory and expectorant effects, explaining its traditional use in bronchitis and coughs. However, the plant contains hepatotoxic pyrrolizidine alkaloids (PAs), and Duke notes a carcinogenic score (1) — a critical safety concern. Commission E has placed restrictions on coltsfoot use, recommending maximum internal use of 4–6 weeks per year and avoiding use in pregnancy, lactation, and in children under 12. Duke rates its overall safety as low (+) and emphasizes that preparations free of PAs are preferred (Duke, 2002).

External Ids

Gbif: 3189486
Powo: urn:lsid:ipni.org:names:433719-1
Wikidata: Q158289
Gbif: 3149879
Wikidata: Q26302

Botanical Description

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]

Height: 30-90 cm
Habit: Erect, branching perennial herb
Leaves: Paired, oval, dotted with tiny translucent oil glands
Flowers: Bright yellow, five-petalled, with numerous stamens and black-dotted petal edges, in flat-topped clusters
Stem: Erect, branching, with two raised longitudinal ridges
Root: Woody rootstock with spreading rhizomes
Fruit: Small, three-valved capsule
Flowering Period: June-September (traditionally around St John's Day, 24 June)

Low perennial herb notable for flowering before its leaves appear: solitary, bright yellow, dandelion-like flower heads emerge on scaly pinkish stalks in very early spring, followed later by large, hoof-shaped (heart-shaped with angular teeth), white-woolly-backed leaves arising directly from the creeping rhizome.[11]

Height: 10-30 cm (flowering stalks); leaves slightly taller once expanded
Habit: Low perennial herb spreading by a creeping rhizome, flowers before leaves appear
Leaves: Hoof-shaped (heart-shaped with angular teeth), white-woolly underneath, appearing after flowering
Flowers: Solitary, bright yellow, dandelion-like heads on scaly pinkish stalks
Stem: Scaly, pinkish flowering stalks appearing before the leaves
Root: Creeping rhizome
Fruit: Small achene with a fluffy white pappus (like a small dandelion clock)
Flowering Period: February-April, before the leaves appear

Habitat

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]

Grows on disturbed, damp or clay-rich waste ground, riverbanks, railway embankments and bare soil; native to Europe, North Africa and temperate Asia and naturalised in North America.[11]

Harvesting

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]

Parts: Flower, Leaf
Season: Summer, at flowering

Flowers are gathered in very early spring before the leaves appear; leaves are gathered later in the season once expanded. Given the plant's pyrrolizidine alkaloid content, harvesting from a positively confirmed patch (not a look-alike) and preferring PA-tested commercial material for internal use is strongly advised.[2]

Parts: Flower, Leaf
Season: Flower in very early spring; leaf later in the growing season

Traditional Uses

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]

Coltsfoot has an ancient European and Chinese tradition, reflected in its Latin name (tussis = cough), as an expectorant and demulcent remedy for coughs, bronchitis and irritated airways; because of its pyrrolizidine alkaloid content, contemporary use is restricted to short courses of PA-controlled preparations under regulatory limits (see contraindications).[1, 2, 12]

Preparations

Standardised extract[1]

Flowering-top extract standardised to hypericin and/or hyperforin content, taken as tablets or capsules; the best-studied clinical form for mood support.

PA-controlled commercial extract[2, 13]

Commercially prepared, pyrrolizidine-alkaloid-tested extract or syrup, the only form recommended for internal use given the plant's natural PA content.

Infusion (short-term, traditional)[2]

Dried flower or leaf infused in hot water; traditional but subject to strict duration/PA-content limits under EU herbal regulation.

Topical preparation[2, 13]

Leaf used topically (e.g. poultice) on intact skin; EMA guidance still notes PA-exposure limits apply to topical products.

Dosage

Standardised extract[1]

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.

PA-controlled internal use[13]

EU regulatory guidance restricts internal use to PA-controlled preparations. The EMA public statement on unsaturated pyrrolizidine alkaloids records a maximum daily intake for internal use of 1 microgram of PAs for at most 6 weeks per year, or 0.1 microgram per day with no duration limit; for cutaneous use the limits are 100 micrograms for at most 6 weeks per year, or 10 micrograms without a duration limit. Not for use in pregnancy, breastfeeding, or children. Note that these are limits on PA intake, not a herb dose — no EMA monograph exists for Tussilago farfara, so there is no official posology for the herb itself. Educational reference only, not a prescription — consult a qualified practitioner and prefer tested commercial products.

Drug Class Interactions

Safety note[18, 19, 20, 21]Avoid
Drug Class: antidepressants-serotonergic
Mechanism: St John's wort raises serotonin activity; combined with SSRIs, SNRIs or MAOIs it can trigger serotonin syndrome (agitation, tremor, sweating, rapid heartbeat). Reviews of clinical reports document serotonin syndrome and lethargy when it is combined with serotonin-reuptake inhibitors.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 19, 22]Avoid
Drug Class: antiretrovirals
Mechanism: Potent CYP3A4 and P-glycoprotein induction lowers antiretroviral levels (indinavir exposure fell ~57%), risking loss of viral control and drug resistance.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 19, 23]Avoid
Drug Class: immunosuppressants
Mechanism: Enzyme and transporter induction reduces ciclosporin and tacrolimus levels; reported to cause subtherapeutic concentrations and transplant rejection.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 24, 25, 26]Avoid
Drug Class: hormonal-therapies
Mechanism: Increased metabolism of ethinylestradiol and progestins reduces contraceptive exposure, causing breakthrough bleeding, ovulation and unplanned pregnancy. Randomised and controlled trials in women confirmed more breakthrough bleeding, reduced progestin levels and evidence of ovulation when St John's wort was added to the pill.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 19, 21]Caution
Drug Class: anticoagulants-antiplatelets
Mechanism: CYP induction increases warfarin clearance and can lower INR, reducing the anticoagulant effect; close monitoring is needed.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 27]Caution
Drug Class: cardiac-glycosides
Mechanism: P-glycoprotein induction lowers digoxin levels (AUC fell ~25% over ten days), which may reduce its effect.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 19, 21]Caution
Drug Class: statins
Mechanism: CYP3A4 induction lowers levels of simvastatin and atorvastatin, potentially weakening their cholesterol-lowering effect.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 19, 21]Caution
Drug Class: cyp3a4-substrates
Mechanism: As a broad CYP3A4 and P-glycoprotein inducer, St John's wort can lower levels of many medicines cleared by this pathway; check each medication individually.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[20, 28, 29]Avoid
Drug Class: chemotherapy-agents
Mechanism: St John's wort strongly induces CYP3A4 and P-glycoprotein, speeding the breakdown and removal of several cancer medicines. In patients it cut the active form of irinotecan (SN-38) by about 42% and reduced imatinib exposure by roughly a third - enough to weaken treatment and risk drug resistance. Do not take St John's wort during chemotherapy.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03

Not documented

References

REF-0842, REF-0843, REF-0844, REF-1789, REF-1790, REF-1791, REF-1792, REF-1793, REF-1794, REF-1795, REF-1796, REF-1797, REF-1798, REF-1799
REF-0910, REF-0911, REF-0912, REF-0913, REF-0914, REF-0915, REF-0916, REF-0917, REF-0918, REF-0919

Pairings

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]

Partner Id: crocus-sativus
Type: caution
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03

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]

Partner Id: rhodiola-rosea
Type: caution
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03

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]

Partner Id: valeriana-officinalis
Type: caution
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03

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]

Partner Id: piper-methysticum
Type: caution
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03

Not documented

Lookalikes Review

Outcome: none-known
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-07
Outcome: has-lookalikes
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-07

Dangerous Lookalikes

Not documented

Safety note[15]Dangerous
Dangerous Plant: adenostyles-alliariae
Confused Part: Broad leaves gathered and brewed as coltsfoot tea; alpendost (and butterbur) have similar rounded leaves and grow in the same damp ground.
Confusion Context: Coltsfoot (Tussilago farfara) leaves are gathered for herbal tea. Alpendost (Adenostyles alliariae) has similar large, rounded leaves and grows in damp woodland and mountain ground; the two are easily confused, especially after the flowering period. Alpendost contains hepatotoxic pyrrolizidine alkaloids: a peer-reviewed case (Sperl et al., 1995) describes an infant who developed liver veno-occlusive disease after long-term 'coltsfoot' tea that was actually alpendost. Butterbur (Petasites) is a similar large-leaved confusion with the same kind of toxicity. Because dried leaf material is especially hard to tell apart, unverified coltsfoot is a real hazard.
Distinguishing Features: Leaf shape: coltsfoot leaves are hoof-shaped (heart-shaped with angular teeth) and white-woolly underneath, usually no more than about 20 cm across. Alpendost leaves are larger, more rounded/kidney-shaped and coarsely toothed., Timing: coltsfoot flowers (yellow dandelion-like heads on scaly stalks) appear BEFORE the leaves, in very early spring; by summer only leaves remain, which is when confusion is greatest., Best practice: because leaves (and dried material) are hard to separate, use coltsfoot only if an expert has confirmed the plant, or buy authenticated, pyrrolizidine-tested material.
Key Test: Do not gather broad heart- or kidney-shaped leaves for 'coltsfoot' tea unless an expert has confirmed the species - alpendost and butterbur leaves look very similar and contain liver-damaging pyrrolizidine alkaloids. Confirm coltsfoot by its early-spring yellow flowers and hoof-shaped white-woolly-backed leaves, or use authenticated material.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-07

References & Sources

  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. Linde, K. et al (2008) 'St John'. Traditional / reference
    https://scholar.google.com/scholar?q=St%20John
  16. Natural Standard (2013) 'Hypericum perforatum (St'. Traditional / reference
    https://scholar.google.com/scholar?q=Hypericum%20perforatum%20%28St
  17. 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
  18. 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
  19. 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
  20. 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
  21. 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
  22. 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
  23. 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
  24. 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
  25. 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
  26. 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
  27. 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
  28. 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
  29. 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
  30. 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
  31. 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
  1. Ahmad, I., Kudaibergenova, B., Ahmad, M. and others (2025) 'Coltsfoot (Tussilago farfara L.; Asteraceae): modern methods of extraction, phytochemistry, nanoparticles synthesis, ethnopharmacology, and biological activities', Natural Product Research, pp. 1-20. doi:10.1080/14786419.2025.2548616 Traditional / reference
    https://doi.org/10.1080/14786419.2025.2548616
  2. Chen, S., Dong, L., Quan, H., Zhou, X. and others (2020) 'A review of the ethnobotanical value, phytochemistry, pharmacology, toxicity and quality control of Tussilago farfara L. (coltsfoot)', Journal of Ethnopharmacology, 267, pp. 113478. doi:10.1016/j.jep.2020.113478 Traditional / reference
    https://doi.org/10.1016/j.jep.2020.113478
  3. Feng, J., Zhang, Y., Qin, X., Gao, T. and others (2022) 'Novel Quinic Acid Glycerates from Tussilago farfara Inhibit Polypeptide GalNAc-Transferase', ChemBioChem, 23(3), pp. e202100539. doi:10.1002/cbic.202100539 Preclinical
    https://doi.org/10.1002/cbic.202100539
  4. Zhao, J., Evangelopoulos, D., Bhakta, S., Gray, A.I. and Seidel, V (2014) 'Antitubercular activity of Arctium lappa and Tussilago farfara extracts and constituents', Journal of Ethnopharmacology, 155(1), pp. 796-800. doi:10.1016/j.jep.2014.06.034 Preclinical
    https://doi.org/10.1016/j.jep.2014.06.034
  5. Avila, C., Breakspear, I., Hawrelak, J., Salmond, S. and Evans, S (2020) 'A systematic review and quality assessment of case reports of adverse events for borage (Borago officinalis), coltsfoot (Tussilago farfara) and comfrey (Symphytum officinale)', Fitoterapia, 142, pp. 104519. doi:10.1016/j.fitote.2020.104519 Meta-analysis / review
    https://doi.org/10.1016/j.fitote.2020.104519
  6. Lee, J., Park, S., Kim, M.J., Kwon, S.J. and others (2019) 'Sesquiterpenoids from Tussilago farfara Flower Bud Extract for the Eco-Friendly Synthesis of Silver and Gold Nanoparticles Possessing Antibacterial and Anticancer Activities', Nanomaterials (Basel), 9(6), pp. 819. doi:10.3390/nano9060819 Preclinical
    https://doi.org/10.3390/nano9060819
  7. Bota, V.B., Neamtu, A.A., Olah, N.K., Chiselita, O. and others (2022) 'A Comparative Analysis of the Anatomy, Phenolic Profile, and Antioxidant Capacity of Tussilago farfara L. Vegetative Organs', Plants (Basel), 11(13), pp. 1663. doi:10.3390/plants11131663 Preclinical
    https://doi.org/10.3390/plants11131663
  8. Boucher, M.A., Cote, H., Pichette, A., Ripoll, L. and Legault, J (2020) 'Chemical composition and antibacterial activity of Tussilago farfara (L.) essential oil from Quebec, Canada', Natural Product Research, 34(4), pp. 545-548. doi:10.1080/14786419.2018.1489384 Preclinical
    https://doi.org/10.1080/14786419.2018.1489384
  9. Li, Z.Y., Zhang, J., Zhang, Y.B., Yang, X.W. and others (2022) 'Polyhydroxylated eudesmane sesquiterpenoids and sesquiterpenoid glucoside from the flower buds of Tussilago farfara', Chinese Journal of Natural Medicines, 20(4), pp. 301-308. doi:10.1016/S1875-5364(21)60120-6 Preclinical
    https://doi.org/10.1016/S1875-5364(21)60120-6
  10. Jang, H., Lee, J.W., Lee, C., Jin, Q. and others (2016) 'Sesquiterpenoids from Tussilago farfara inhibit LPS-induced nitric oxide production in macrophage RAW 264.7 cells', Archives of Pharmacal Research, 39(1), pp. 127-132. doi:10.1007/s12272-015-0667-7 Preclinical
    https://doi.org/10.1007/s12272-015-0667-7
  11. Royal Botanic Gardens, Kew (n.d.). Available at: https://powo.science.kew.org Traditional / reference
    https://powo.science.kew.org
  12. Westendorf, J., Czok, G., Marquardt, R., Nausner, M., Krauer, B. and Paul, H.L (1988) 'Pyrrolizidine alkaloid content of Tussilago farfara plants from different regions and preparations', pp. 903--909. Traditional / reference
    https://scholar.google.com/scholar?q=Pyrrolizidine%20alkaloid%20content%20of%20Tussilago%20farfara%20plants%20from%20different%20regions%20and%20preparations
  13. European Medicines Agency (HMPC) (2021) 'Public statement on the use of herbal medicinal products containing toxic, unsaturated pyrrolizidine alkaloids (PAs), including recommendations regarding contamination of herbal medicinal products with PAs, Revision 1'. Available at: https://www.ema.europa.eu/en/documents/public-statement/public-statement-use-herbal-medicinal-products-containing-toxic-unsaturated-pyrrolizidine-alkaloids-pas-including-recommendations-regarding-contamination-herbal-medicinal-products-pyrrolizidine_en.pdf Traditional / reference
    https://www.ema.europa.eu/en/documents/public-statement/public-statement-use-herbal-medicinal-products-containing-toxic-unsaturated-pyrrolizidine-alkaloids-pas-including-recommendations-regarding-contamination-herbal-medicinal-products-pyrrolizidine_en.pdf
  14. 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
  15. Sperl, W. and Stuppner, H. and Gassner, I. and Judmaier, W. and Dietze, O. and Vogel, W (1995) 'Reversible hepatic veno-occlusive disease in an infant after consumption of pyrrolizidine-containing herbal tea', European Journal of Pediatrics, 154(2), pp. 112-6. doi:10.1007/BF01991912 Clinical study
    https://doi.org/10.1007/BF01991912

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.