Interaction: St Johns Wort × Immunosuppressants
St Johns Wort × Immunosuppressants
Severity: CRITICAL Evidence: well-established
Mechanism
St. John's wort induces CYP3A4 and P-gp, increasing metabolism of tacrolimus and other immunosuppressants.
Effect
Subtherapeutic immunosuppressant levels; transplant rejection risk
Management
Absolutely avoid combination in transplant patients.
Source
Mai I et al. Clin Pharmacol Ther 2000; Hebert MF et al. Clin Pharmacol Ther 2004
⚠️ 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.