St John’sWort(continued)
▶St John’s Wortis predicted to decrease the concentration of
elvitegravir. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the effects of
ergotamine.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
erlotinib.rTheoretical
▶St John’s Wortis predicted to decrease the efficacy of
etonogestrel. MHRA advises avoid. For FSRH guidance, see
Contraceptives, interactionsp. 497.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
etravirine. Avoid.rStudy
▶St John’s Wortis predicted to decrease the concentration of
everolimus. Avoid or adjust dose.rStudy
▶St John’s Wortis predicted to decrease the exposure to
exemestane.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
fesoterodine. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
fingolimod. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
fosaprepitant. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
gefitinib. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
glecaprevir. Avoid.rStudy
▶St John’s Wortis predicted to markedly decrease the exposure
tograzoprevir. Avoid.rStudy
▶St John’s Wortis predicted to decrease the concentration of
guanfacine. Adjust dose.oTheoretical
▶St John’s Wortis predicted to decrease the exposure toHIV-
protease inhibitors. Avoid.rStudy
▶St John’s Wortis predicted to decrease the efficacy ofhormone
replacement therapy.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
ibrutinib. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
idelalisib. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
imatinib.oStudy
▶St John’s Wortslightly decreases the exposure toirinotecan.
Avoid.rStudy
▶St John’s Wortdecreases the exposure toivabradine. Avoid.
oStudy
▶St John’s Wortis predicted to decrease the exposure to
ivacaftor.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
ixazomib. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
lapatinib. Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
ledipasvir. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the efficacy of
levonorgestrel. MHRA advises avoid. For FSRH guidance, see
Contraceptives, interactionsp. 497.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
lurasidone. Monitor and adjust dose.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
macitentan. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
maraviroc. Avoid.rTheoretical
▶St John’s Wortmoderately decreases the exposure to
midazolam. Monitor and adjust dose.oStudy
▶St John’s Wortis predicted to decrease the exposure to
midostaurin. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
naloxegol. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
netupitant.oTheoretical
▶St John’s Wortis predicted to decrease the concentration of
nevirapine. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
nilotinib. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
nintedanib.oStudy▶St John’s Wortis predicted to decrease the efficacy of
norethisterone. MHRA advises avoid. For FSRH guidance, see
Contraceptives, interactionsp. 497.rAnecdotal
▶St John’s Wortis predicted to decrease the exposure to
olaparib. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
ombitasvir. Avoid.rTheoretical
▶St John’s Wortdecreases the exposure toopioids(methadone).
Monitor and adjust dose.rStudy→Also seeTABLE 13p. 850
▶St John’s Wortmoderately decreases the exposure toopioids
(oxycodone). Adjust dose.oStudy
▶St John’s Wortis predicted to decrease the exposure to
osimertinib. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
palbociclib. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
paliperidone.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
panobinostat. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
paritaprevir(with ritonavir and ombitasvir). Avoid.r
Study
▶St John’s Wortis predicted to decrease the exposure to
phosphodiesterase type-5 inhibitors.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
pibrentasvir. Avoid.rStudy
▶St John’s Wortslightly decreases the exposure topioglitazone.
nStudy
▶St John’s Wortis predicted to decrease the exposure to
pitolisant. Monitor and adjust dose.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
ponatinib. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
quetiapine.oStudy
▶St John’s Wortis predicted to decrease the exposure to
ranolazine. Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
ribociclib. Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
rilpivirine. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
rolapitant. Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
ruxolitinib. Monitor and adjust dose.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
simeprevir. Avoid.rStudy
▶St John’s Wortis predicted to decrease the concentration of
sirolimus. Monitor and adjust dose.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
sofosbuvir. Avoid.rStudy
▶St John’s Wortslightly decreases the exposure tostatins
(atorvastatin).nStudy
▶St John’s Wortmoderately decreases the exposure tostatins
(simvastatin).oStudy
▶St John’s Wortdecreases the concentration oftacrolimus.
Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure totaxanes
(cabazitaxel). Avoid.rStudy
▶St John’s Wortis predicted to decrease the concentration of
temsirolimus. Avoid.rTheoretical
▶St John’s Wortis predicted to decrease the exposure to
tenofovir alafenamide. Avoid.oTheoretical
▶St John’s Wortpotentially decreases the exposure to
theophylline.rAnecdotal
▶St John’s Wortis predicted to decrease the exposure to
ticagrelor.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
tivozanib. Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
tofacitinib.oStudy
▶St John’s Wortis predicted to decrease the exposure to
tolvaptan.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
topotecan.rTheoretical992 St John’s Wort—St John’s Wort BNFC 2018 – 2019
Interactions|Appendix 1A1