Drug interactions
Docetaxel + St john's wort
Severity: Moderate
Docetaxel 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, which may lower docetaxel concentrations. This could reduce anticancer efficacy, and the effect disappears unpredictably after stopping the herb.
What this interaction means in plain words
Docetaxel 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.
Why it happens
St John's wort induces CYP3A4 and P-glycoprotein, increasing docetaxel clearance.
What to do
Advise patients to stop St John's wort before starting docetaxel. If it was recently stopped, monitor for toxicity as induction wanes.
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?
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Other interactions of Docetaxel
Frequently asked questions
Can I take Docetaxel with St john's wort?
MediHelp rates the interaction as moderate. Docetaxel 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, which may lower docetaxel concentrations. This could reduce anticancer efficacy, and the effect disappears unpredictably after stopping the herb.
How serious is the interaction between Docetaxel 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 patients to stop St John's wort before starting docetaxel. If it was recently stopped, monitor for toxicity as induction wanes.
What other medicines interact with Docetaxel?
MediHelp also lists interactions of Docetaxel with, for example, Adenovirus types 4 and 7 live, Atazanavir, Belatacept. The full list is on the Docetaxel page.
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