Selected 3A4 Substrates/St. John's Wort
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
When taken together, St. John's wort may cause your body to process your HIV medication more quickly.
What might happen:
St. John's wort may decrease the amount of the HIV medicine in your body. The HIV medicine may not work against your HIV infection.
What you should do about this interaction:
Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these medicines together. Your doctor may want to run some blood tests to see if your HIV therapy is still working.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.Agenerase (amprenavir) Oral Solution US prescribing information. GlaxoSmithKline May, 2005.
2.Crixivan (indinavir sulfate) US prescribing information. Merck & Co., Inc. February, 2011.
3.Fortovase (saquinavir) US prescribing information. Roche Laboratories, Inc. December, 2004.
4.Invirase (saquinavir mesylate) US prescribing information. Roche Laboratories, Inc. February, 2012.
5.Reyataz (atazanavir sulfate) US prescribing information. Bristol-Myers Squibb Company January, 2013.
6.Prezista (darunavir) US prescribing information. Tibotec Inc. February, 2013.
7.Lexiva (fosamprenavir calcium) US prescribing information. GlaxoSmithKline February, 2013.
8.Kaletra (lopinavir/ritonavir tablets) US prescribing information. Abbott Laboratories January, 2013.
9.Viracept (nelfinavir mesylate) US prescribing information. Agouron Pharmaceuticals, Inc. April, 2012.
10.Norvir (ritonavir) US prescribing information. Abbott Laboratories November, 2012.
11.Aptivus (tipranavir) US prescribing information. Boehringer Ingelheim Pharmaceuticals, Inc. February, 2012.
12.Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir) prescribing information. Gilead Sciences, Inc. August, 2012.
13.Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM, Falloon J. Indinavir concentrations and St John's wort. Lancet 2000 Feb 12;355(9203):547-8.
14.Phansalkar S, Desai AA, Bell D, Yoshida E, Doole J, Czochanski M, Middleton B, Bates DW. High-priority drug-drug interactions for use in electronic health records. J Am Med Inform Assoc 2012 Sep-Oct; 19(5):735-43.
