Drug interactions
Cabazitaxel + St john's wort
Severity: Major
Cabazitaxel and St john's wort: major 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 may reduce cabazitaxel exposure, risking reduced efficacy. Herbal use is often undisclosed, so it is easily missed.
What this interaction means in plain words
Cabazitaxel and St john's wort can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Hyperforin-mediated activation of PXR induces CYP3A4 and P-glycoprotein.
What to do
Advise patients to stop St John's wort before starting cabazitaxel and avoid it throughout treatment. Labeling recommends avoiding it.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Cabazitaxel
Frequently asked questions
Can I take Cabazitaxel with St john's wort?
MediHelp rates the interaction as major. Cabazitaxel and St john's wort can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. St John's wort induces CYP3A4 and may reduce cabazitaxel exposure, risking reduced efficacy. Herbal use is often undisclosed, so it is easily missed.
How serious is the interaction between Cabazitaxel and St john's wort?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to stop St John's wort before starting cabazitaxel and avoid it throughout treatment. Labeling recommends avoiding it.
What other medicines interact with Cabazitaxel?
MediHelp also lists interactions of Cabazitaxel with, for example, Adenovirus types 4 and 7 live, Atazanavir, Bcg intravesical live. The full list is on the Cabazitaxel page.
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