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Is St. John's Wort Safe with CYP450-metabolized drugs (general)?

⚠️ HIGH SEVERITY
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CYP450-metabolized drugs (general) St. John's Wort
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Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature

WHAT YOU NEED TO KNOW

Inform your pharmacist or doctor if you are taking St. John's Wort alongside any prescription medication. St. John's Wort can speed up the breakdown of many drugs through CYP450 enzyme induction, potentially making your medication less effective. Do not start St. John's Wort without first consulting a healthcare provider.

Why this interaction occurs

St. John's Wort (Hypericum perforatum) is a known inducer of cytochrome P450 enzymes, particularly CYP3A4 and CYP2C9. This pharmacokinetic interaction can reduce plasma concentrations of a wide range of medications, compromising their therapeutic effectiveness.

Evidence

Evidence level: strong.

Data source

PubMed - PMID 41901246

Reported safety data

The FDA’s adverse event reporting system (FAERS) has received 1,476,521 reports mentioning CYP450-metabolized drugs (general). This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the CYP450-metabolized drugs (general) + 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

Can I take St. John's Wort with CYP450-metabolized drugs (general)?
Avoid unless your doctor or pharmacist directs otherwise. Inform your pharmacist or doctor if you are taking St. John's Wort alongside any prescription medication. St. John's Wort can speed up the breakdown of many drugs through CYP450 enzyme induction, potentially making your medication less effective. Do not start St. John's Wort without first consulting a healthcare provider.
Does St. John's Wort affect how well CYP450-metabolized drugs (general) works?
St. John's Wort (Hypericum perforatum) is a known inducer of cytochrome P450 enzymes, particularly CYP3A4 and CYP2C9. This pharmacokinetic interaction can reduce plasma concentrations of a wide range of medications, compromising their therapeutic effectiveness.

Related interactions

St. John's Wort and cyclosporine St. John's Wort and warfarin St. John's Wort and indinavir St. John's Wort and oral contraceptives St. John's Wort and Tricyclic Antidepressants (Amitriptyline, Nortriptyline, Doxepin, Imipramine, Desipramine, Amoxapine) St. John's Wort and Direct-Acting Oral Anticoagulants (DOACs) — excluding Dabigatran St. John's Wort and Serotonergic Antidepressants (SSRIs, SNRIs) St. John's Wort and Sertraline

All St. John's Wort interactions →  ·  All CYP450-metabolized drugs (general) interactions →

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