St. John's wort
Brand: (no brand; generic only)
No boxed warning on the current FDA label.
- Caution
- Strong CYP3A4 and P-gp inducer that lowers levels of contraceptives, warfarin, DOACs, and transplant drugs; serotonin syndrome with antidepressants.
Common side effects
- Photosensitivity
- Dry mouth
- Dizziness
- Stomach upset
Key interactions
- Powerful enzyme inducer: lowers levels of contraceptives, warfarin, DOACs, and many others
- Serotonin syndrome risk with SSRIs, SNRIs, and triptans
- Reduces the effect of transplant anti-rejection drugs
Counseling points
- Tell the pharmacy you take it. It interacts with an unusually wide range of prescriptions
- Use a backup contraceptive method
- Use sun protection
- Not evaluated by FDA for effectiveness
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High-yield study aid for exam prep, not a substitute for the package insert or a pharmacist’s dispensing reference.