Drug-Nutrient Interactions and Drug-Supplement Interactions | Drug Interactions with St. John's Wort

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Learn More About Drug-Nutrient Interactions and Drug-Supplement Interactions

Examples of Dietary Supplement Interactions

Dietary supplements can affect the way your body processes prescription and over-the-counter drugs. When this happens, your medicine may not work the way it should. This is called a drug-supplement interaction. It can cause serious problems.

St. John's wort reacts with many different types of drugs, which are listed below:

  • Alprazolam. Can increase how fast the body gets rid of alprazolam, decreasing its effectiveness.
  • Aminolevulinic acid. Can increase the chances of sunburn, blistering, or rashes on areas of skin exposed to sunlight.
  • Amitriptyline. Can decrease the effectiveness of amitriptyline by increasing how quickly the body breaks it down.
  • Birth control pills. Can increase the breakdown of estrogen, decreasing the effectiveness of birth control.
  • Cyclosporine. Can increase how quickly the body breaks cyclosporine down.
  • Digoxin. Can decrease the amount of digoxin the body absorbs, decreasing the effects of digoxin.
  • Fenfluramine. Can cause too much serotonin, causing serious side effects including heart problems, shivering, nausea, headache, and anxiety.
  • Imatinib. Can increase how quickly the body gets rid of imatinib, decreasing the effectiveness of imatinib.
  • Irinotecan. Can increase how fast the body breaks down irinotecan, decreasing the effectiveness.
  • Medicines changed by the liver.* Some medicines are processed and broken down using the liver's cytochrome P450 enzyme system. St. Johns wort can increase how quickly the liver breaks down some medicines, decreasing their effectiveness.
  • Antidepressants. Can increase serotonin too much and cause serious side effects including heart problems, shivering, and anxiety.
  • Medicines for HIV/AIDS. Can increase how quickly the body breaks down these medicines, decreasing their effectiveness.
  • Narcotic pain medicines. Can decrease how fast the body gets rid of some medicines for pain, increasing side effects.
  • Medicines moved by pumps in cells (P-Glycoprotein Substrates). Can make these pumps more active and decrease how much of some medicines get absorbed by the body, decreasing effectiveness.
  • Medicines that increase sensitivity to sunlight. St. John's wort can also increase your sensitivity to sunlight. Taking St. John's wort along with these medicines can increase the chances of sunburn, blistering or rashes on areas of skin exposed to sunlight.
  • Meperidine. Can increase serotonin too much, causing serious side effects including heart problems, shivering, and anxiety.
  • Mephenytoin. Can increase how quickly this medicine is broken down by the body.
  • Nefazodone. Can increase serotonin too much, causing serious side effects including heart problems, shivering, and anxiety.
  • Nortriptyline. Can increase how quickly the body breaks down nortriptyline, decreasing effectiveness of nortriptyline.
  • Paroxetine. Can increase serotonin too much, causing serious side effects including heart problems, shivering, and anxiety.
  • Pentazocine. Can increase serotonin too much, causing serious side effects including heart problems, shivering, and anxiety.
  • Phenobarbital. Can increase how quickly the body breaks down phenobarbital, decreasing effectiveness of  phenobarbital.
  • Phenprocoumon. Increases how quickly the body breaks down phenprocoumon, decreasing effectiveness of phenprocoumon.
  • Phenytoin. Can increase how quickly the body breaks down phenytoin, decreasing  the effectiveness of phenytoin and increasing the possibility of seizures.
  • Reserpine. Can decrease the effects of reserpine.
  • Sedative medicines (barbiturates). Can decrease the effectiveness of sedative medicines.
  • Sertraline. Can increase serotonin too much, causing serious side effects including heart problems, shivering, and anxiety.
  • Tacrolimus. Can increase how quickly the body breaks down tacrolimus, decreasing effectiveness.
  • Tramadol. Can increase serotonin too much, causing serious side effects including confusion, shivering, and stiff muscles.
  • Warfarin. Can increase the breakdown and decrease the effectiveness of warfarin, possibly increasing the risk of clotting.

*Examples of medicines changed by the liver can include: amitriptyline, diazepam, zileuton, celecoxib, diclofenac, fluvastatin, glipizide, ibuprofen, irbesartan, losartan, phenytoin, piroxicam, tamoxifen, tolbutamide, torsemide, warfarin, lovastatin, ketoconazole, itraconazole, fexofenadine, triazolam, and many others.

Written by familydoctor.org editorial staff

Created: 02/14

Learn More About Drug-Nutrient Interactions and Drug-Supplement Interactions

Examples of Dietary Supplement Interactions

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