Herbal Supplements in the Perioperative Period

Safety and Interactions of Passion Flower

The Society for Perioperative Assessment and Quality Improvement (SPAQI) recommends that passion flower can be continued perioperatively due to its anxiolytic effects and good safety profile, with no concerns about cytochrome P450 interactions 1
Passion flower does not inhibit CYP3A4 and can be safely used without dose adjustments for medications metabolized by CYP3A4 1
Unlike herbs like St. John's wort, a potent inducer of CYP3A4, and grapefruit extract, a CYP3A4 inhibitor, passion flower is not listed among herbs that have significant interactions with the cytochrome P450 system 2, 3
The SPAQI guidelines exempt passion flower from the requirement to hold herbs that interact with CYP enzymes for 2 weeks before surgery 1
St. John's wort is a potent inducer of CYP3A4, while grapefruit extract and fennel inhibit CYP3A4 2, 4
Hawthorn has potential cardiovascular effects but is not listed as having significant CYP3A4 interaction potential 4
No special monitoring for drug interactions related to CYP3A4 inhibition is necessary when using passion flower, and it can be continued before surgical procedures 1

Passion flower can be used as an anxiolytic supplement that can be continued during the perioperative period, with a demonstrated reduction in anxiety and good safety profile 1
It can be safely used as an add-on treatment without concerns about metabolic interactions, although specific interactions with medications like sertraline are not detailed in the provided references 1
Passion flower may provide beneficial anxiolytic effects without the concern of metabolic drug interactions, making it a relatively safe herbal supplement from a drug interaction perspective 1