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Drug interactions

Avanafil + St john's wort

Severity: Moderate

Avanafil and St john's wort: moderate interaction.

Last updated

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

St John's wort induces CYP3A4 and P-glycoprotein and may reduce avanafil exposure. Erectile response may be reduced.

What this interaction means in plain words

Avanafil and St john's wort can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.

Evidence level: Moderate

Why it happens

Induction of CYP3A4 increases avanafil metabolism.

What to do

Advise against concurrent use if efficacy is lost, or monitor response closely. Consider an alternative to avanafil.

What to ask your pharmacist

  • Should I take them at different times of day?
  • Does the dose of either medicine need to change?
  • Is there anything I should avoid, such as alcohol or certain foods, while on both?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Avanafil with St john's wort?

MediHelp rates the interaction as moderate. Avanafil and St john's wort can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. St John's wort induces CYP3A4 and P-glycoprotein and may reduce avanafil exposure. Erectile response may be reduced.

How serious is the interaction between Avanafil and St john's wort?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise against concurrent use if efficacy is lost, or monitor response closely. Consider an alternative to avanafil.

What other medicines interact with Avanafil?

MediHelp also lists interactions of Avanafil with, for example, Amyl nitrite, Atazanavir, Clarithromycin. The full list is on the Avanafil page.

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