Is St. John's Wort (Hypericum perforatum) Safe with sirolimus?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Avoid taking St. John's Wort while on sirolimus. Inform your doctor if you are using or plan to use this herbal supplement.
Why this interaction occurs
St. John's Wort is a CYP3A4 and P-gp inducer that can significantly decrease sirolimus blood concentrations, potentially leading to subtherapeutic levels and risk of transplant rejection or treatment failure.
Evidence
Evidence level: strong.
Data source
FDA Drug Label
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 14,104 reports mentioning sirolimus. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the sirolimus + 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 (Hypericum perforatum) interactions → · All sirolimus interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.