St. John's wort Health Article

What other drugs will affect St. John's wort?

St. John's wort may interact with many other medicines, possibly increasing side effects or resulting in decreased therapeutic effects. Do not take St. John's wort without first talking to your doctor if you are taking any other medicines, especially any of the following:

• a monoamine oxidase inhibitor such as tranylcypromine (Nardil), phenelzine (Parnate), or isocarboxazid (Marplan);

• a selective serotonin reuptake inhibitor such as citalopram (Celexa), fluvoxamine (Luvox), fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft);

• a migraine medicine such as almotriptan (Axert), frovatriptan (Frova), eletriptan (Relpax), naratriptan (Amerge), sumatriptan (Imitrex), or zolmitriptan (Zomig);

• a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil);

• furazolidone (Furoxone);

• linezolid (Zyvox);

• procarbazine (Matulane);

• selegiline (Eldepryl);

• bupropion (Wellbutrin, Zyban);

• trazodone (Desyrel) or nefazodone (Serzone);

• venlafaxine (Effexor);

• mirtazapine (Remeron);

• sodium oxybate (Xyrem);

• levomethadyl acetate (Orlaam);

• cyclosporine (Sandimmune, Neoral, Gengraf);

• an HIV/AIDS protease inhibitor such as indinavir (Crixivan), lopinavir-ritonavir (Kaletra), amprenavir (Agenerase), nelfinavir (Viracept), ritonavir (Norvir), or saquinavir (Fortovase, Invirase); or

• an HIV/AIDS non-nucleoside reverse transcriptase inhibitor such as delavirdine (Rescriptor), efavirenz (Sustiva), or nevirapine (Viramune).

You may not be able to take St. John's wort, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

St. John's wort may increase the effects of other drugs that cause drowsiness or dizziness, including antidepressants, alcohol, sedatives (used to treat insomnia), pain relievers, anxiety medicines, muscle relaxants, other antihistamines, and topical medications that contain an antihistamine (e.g., anti-itch creams). Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor.

Drugs other than those listed here may also interact with St. John's wort or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines or herbal/health supplements.

Where can I get more information?

Your doctor, pharmacist, or health care provider may have more information about St. John's wort.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.