Drug interactions
Cariprazine + St john's wort
Severity: Major
Cariprazine and St john's wort: major interaction.
Last updated Sources: US FDA label
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 cariprazine and active metabolite levels, risking relapse. Its serotonergic activity adds further unpredictability in psychiatric patients.
What this interaction means in plain words
Cariprazine 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 induction of CYP3A4 increases cariprazine clearance.
What to do
Advise patients to avoid St John's wort. If already taking it, monitor psychiatric response when stopping or starting 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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References
Other interactions of Cariprazine
Frequently asked questions
Can I take Cariprazine with St john's wort?
MediHelp rates the interaction as major. Cariprazine 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 P-glycoprotein and may reduce cariprazine and active metabolite levels, risking relapse. Its serotonergic activity adds further unpredictability in psychiatric patients.
How serious is the interaction between Cariprazine 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 avoid St John's wort. If already taking it, monitor psychiatric response when stopping or starting it.
What other medicines interact with Cariprazine?
MediHelp also lists interactions of Cariprazine with, for example, Alfentanil, Amisulpride, Amobarbital. The full list is on the Cariprazine page.
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