St Johns Wort and Tacrolimus: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining St Johns Wort and Tacrolimus unless specifically directed by your doctor.
How St Johns Wort interacts with Tacrolimus
St John's wort induces CYP3A4 and P-glycoprotein, substantially lowering tacrolimus blood concentrations and risking acute organ rejection in transplant recipients.
What you should do
Avoid St John's wort entirely in transplant patients; counsel on herbal product avoidance at every clinic visit.
Key facts
Severity
Major — avoid combination
Mechanism
St John's wort induces CYP3A4 and P-glycoprotein, substantially lowering tacrolimus blood concentrations and risking acu...
Action
Avoid St John's wort entirely in transplant patients; counsel on herbal product avoidance at every clinic visit.
Frequently asked questions
Can I take St Johns Wort and Tacrolimus together?
No — this combination should generally be avoided. Avoid St John's wort entirely in transplant patients; counsel on herbal product avoidance at every clinic visit.
What is the severity of this interaction?
The interaction between St Johns Wort and Tacrolimus is classified as Major — avoid combination. St John's wort induces CYP3A4 and P-glycoprotein, substantially lowering tacrolimus blood concentrations and risking acute organ rejection in transplant recipients.
What should I do if I'm prescribed both?
Avoid St John's wort entirely in transplant patients; counsel on herbal product avoidance at every clinic visit. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.