Is St. John's Wort (Hypericum perforatum) Safe with tacrolimus?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Do not take St. John's Wort while on tacrolimus. If you are currently using it, tell your transplant team immediately so your tacrolimus dose and blood levels can be monitored and adjusted.
Why this interaction occurs
St. John's Wort is a strong CYP3A inducer. It may significantly decrease tacrolimus whole blood trough concentrations, increasing the risk of organ rejection.
Evidence
Evidence level: strong.
Data source
FDA Drug Label
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 130,929 reports mentioning tacrolimus. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the tacrolimus + 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 tacrolimus interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.