Is St. John's Wort Safe with indinavir?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Do not take St. John's Wort if you are on indinavir or any antiretroviral therapy. This combination can cause sub-therapeutic drug levels, leading to virologic failure and potential drug resistance. Consult your HIV specialist immediately.
Why this interaction occurs
St. John's Wort strongly induces CYP3A4 and P-glycoprotein, significantly reducing indinavir plasma concentrations to sub-therapeutic levels, which can result in HIV treatment failure and the development of resistant viral strains.
Evidence
Evidence level: strong.
Data source
PubMed - PMID 18637192
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 1,118 reports mentioning indinavir. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the indinavir + 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 indinavir interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.