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Is St. John's Wort Safe with digoxin?

⚠️ HIGH SEVERITY
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digoxin 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

Measure serum digoxin concentrations before starting St. John's Wort. Continue monitoring and increase digoxin dose by approximately 20% to 40% as necessary. Consult your healthcare provider before use.

Why this interaction occurs

St. John's Wort is listed as an agent that decreases digoxin concentrations, likely via P-glycoprotein induction, which can reduce digoxin absorption and increase its elimination, potentially leading to loss of therapeutic effect.

Evidence

Evidence level: strong.

Data source

FDA Drug Label

Reported safety data

The FDA’s adverse event reporting system (FAERS) has received 64,171 reports mentioning digoxin. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the digoxin + 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 digoxin?
Avoid unless your doctor or pharmacist directs otherwise. Measure serum digoxin concentrations before starting St. John's Wort. Continue monitoring and increase digoxin dose by approximately 20% to 40% as necessary. Consult your healthcare provider before use.
How long should I wait between digoxin and St. John's Wort?
Measure serum digoxin concentrations before starting St. John's Wort. Continue monitoring and increase digoxin dose by approximately 20% to 40% as necessary. Consult your healthcare provider before use.
Does St. John's Wort affect how well digoxin works?
St. John's Wort is listed as an agent that decreases digoxin concentrations, likely via P-glycoprotein induction, which can reduce digoxin absorption and increase its elimination, potentially leading to loss of therapeutic effect.

Related interactions

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All St. John's Wort interactions →  ·  All digoxin interactions →

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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.