Affected Drugs | Interaction |
---|---|
Some antipsychotics (for example, clozapine) | St. John's wort may reduce the effectiveness of antipsychotics. |
Benzodiazepines | St. John’s wort may reduce the effectiveness of these medications in reducing anxiety and may increase the risk of side effects such as drowsiness. |
Cyclosporine | St. John’s wort may reduce blood levels of cyclosporine, making it less effective, with potentially dangerous results (such as rejection of an organ transplant). |
Digoxin | St. John’s wort may reduce blood levels of digoxin, making it less effective, with potentially dangerous results. |
Factor Xa inhibitors (for example, rivaroxaban) used as blood thinners | St. John’s wort may reduce blood levels of factor Xa inhibitors. |
Imatinib (a cancer chemotherapy drug) | St. John's wort may reduce the effectiveness of imatinib. |
Iron | St. John’s wort may reduce iron absorption. |
Monoamine oxidase inhibitors (MAOIs) | St. John’s wort may intensify the effects of MAOIs, possibly causing very high blood pressure that requires emergency treatment. |
Nonnucleoside reverse transcriptase inhibitors | St. John’s wort increases the metabolism of these medications, reducing their effectiveness. |
Oral contraceptives | St. John’s wort increases the metabolism of oral contraceptives, reducing their effectiveness. |
Omeprazole | St. John’s wort decreases blood levels of omeprazole, reducing its effectiveness. |
Oxycodone | St. John's wort may reduce the effectiveness of oxycodone. |
Medications metabolized by a certain enzyme (such as clopidogrel) | St. John's wort may reduce the effectiveness of these medications. |
Phenytoin | St. John's wort may reduce the effectiveness of phenytoin. |
Photosensitizing medications (such as amiodarone, naproxen, sulfonylureas [such as glipizide], and sulfonamide antibiotics) | When taken with these medications, St. John’s wort may increase the risk of sun sensitivity. |
Protease inhibitors (such as indinavir or saquinavir), which are used to treat human immunodeficiency virus (HIV) infection | St. John’s wort may reduce blood levels of protease inhibitors, making them less effective. |
Selective serotonin reuptake inhibitors (SSRIs, such as fluoxetine, paroxetine, and sertraline) | St. John’s wort may intensify the effects of these medications. |
Tricyclic antidepressants | St. John’s wort may decrease the effects of these medications. |
Warfarin | St. John’s wort may reduce blood levels of warfarin, making it less effective and clot formation more likely. |