Interaction · Supplement
St. John's Wort + DOACs: use with caution
Enzyme induction lowers DOAC levels — a real clot risk; do not combine.
- Overall grade
- Grade B
- Last revised
- 0
- graded outcomes
- 0
- references listed
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What is uncertain
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- Watch with St. John's Wort: About St. John's Wort
The evidence in words
The interaction
St. John's Wort and DOACs — a caution interaction. Enzyme induction lowers DOAC levels — a real clot risk; do not combine.
What to do
Do not combine these casually. The interaction can matter clinically — bring it to the prescriber who manages the medication before stacking them.
About St. John's Wort
St. John's Wort (Hypericum perforatum) is a flowering herb with real antidepressant activity, standardized to hypericin and hyperforin. It is also the classic teaching example of a botanical that interferes with prescription drugs.
The bigger picture
Supplement–drug and supplement–supplement interactions are the reason a stack should be read as a system, not a list. This platform's interactions graph maps them; the medication side always belongs with the person who prescribes it.
Related reading
Entries that share this one's tags or conditions.
- St. John's Wort + Anticoagulants (warfarin): use with cautionInduces metabolism — reduces anticoagulant effect.Evidence grade B
- St. John's Wort + Digoxin: use with cautionSt John's Wort lowers digoxin levels via P-glycoprotein induction.Evidence grade B
- St. John's Wort + Immunosuppressants: use with cautionSt John's Wort induces CYP3A4, lowering cyclosporine and risking transplant rejection.Evidence grade B
- St. John's Wort + Oral contraceptives: use with cautionLowers contraceptive levels — real failure risk.Evidence grade B
Sources
This entry lists no references of its own — it is assembled from the entries it links to, whose sources are on their pages.
Last revised . A grade is this entry's reading of the evidence, not medical advice.