Is St. John's Wort Safe with Codeine?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Consult your doctor before combining. St. John's Wort may reduce pain relief by shifting codeine metabolism; report if analgesia seems reduced.
Why this interaction occurs
St. John's Wort induces CYP3A4, which can push codeine toward inactive norcodeine rather than CYP2D6-mediated activation to morphine, potentially reducing analgesic effect. Clinical magnitude is uncertain.
Evidence
Evidence level: strong.
Data source
FDA opioid labeling; CYP450 induction literature
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 100,795 reports mentioning Codeine. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the Codeine + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All St. John's Wort interactions → · All Codeine interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.