Interaction: St Johns Wort × Digoxin
St Johns Wort × Digoxin
Severity: CRITICAL Evidence: well-established
Mechanism
St. John's wort induces P-glycoprotein, increasing digoxin efflux and reducing plasma levels.
Effect
Subtherapeutic digoxin levels; loss of heart rate control
Management
Avoid combination. If unavoidable, monitor digoxin levels and adjust dose.
Source
Johne A et al. Clin Pharmacol Ther 1999
⚠️ 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.