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Interactions of St John's Wort

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The CSM has advised that St John's Wort should not be used with:

  • indinavir
  • warfarin
  • cyclosporin
  • oral contraceptives
  • theophylline
  • digoxin

Although there is no direct evidence, it is likely that clinically important interactions may occur with:

  • other HIV protease inhibitors (saquinavir, nelfinavir ritonavir)
  • HIV non-nucleoside reverse transcriptase inhibitors (nevirapine, efavirnez)
  • anticonvulsants (phenobarbitone, phenytoin, carbamazepine)

Additionally St John's Wort:

  • may interact with selective serotonin reuptake inhibitors
  • may have pharmacodynamic interactions with the triptans used to treat migraine

Reference:

  • CEM/CMO/2000/4

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