St Johns Wort × Antiretrovirals

Severity: CRITICAL Evidence: well-established

Mechanism

St. John's wort induces CYP3A4 and P-gp, dramatically reducing protease inhibitor and NNRTI levels.

Effect

Subtherapeutic antiretroviral levels; treatment failure; viral resistance

Management

Absolutely avoid combination. Life-threatening interaction for HIV patients.

Source

Piscitelli SC et al. Lancet 2000; de Maat MM et al. J AIDS 2001

⚠️ CRITICAL INTERACTION: This combination should be AVOIDED.

Disclaimer

This interaction record is for informational purposes only and does not constitute medical advice. Always consult a healthcare provider before starting or stopping any supplement or medication.