St Johns Wort × Benzodiazepines

Severity: MODERATE Evidence: probable

Mechanism

St. John's wort induces CYP3A4, increasing metabolism of alprazolam, midazolam, and other benzodiazepines.

Effect

Reduced sedative effect; decreased benzodiazepine efficacy

Management

Monitor for reduced efficacy. May need dose adjustment.

Source

Kawaguchi A et al. J Clin Pharmacol 2004

⚠️ MODERATE INTERACTION: Monitor closely if this combination is used.

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.