St Johns Wort × Cyclosporine

Severity: CRITICAL Evidence: well-established

Mechanism

St. John's wort induces CYP3A4 and P-glycoprotein, dramatically increasing cyclosporine metabolism.

Effect

Subtherapeutic cyclosporine levels; transplant rejection risk

Management

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

Source

Breidenbach T et al. Transplantation 2000; Ruschitzka F et al. Lancet 2000

⚠️ 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.