Drug interactions
Dronabinol + St john's wort
Severity: Moderate
Dronabinol 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 may lower dronabinol concentrations, reducing efficacy. Both agents also affect mood and CNS function, so unpredictable effects are possible.
What this interaction means in plain words
Dronabinol 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 (via PXR activation), increasing dronabinol clearance.
What to do
Monitor the clinical response to dronabinol and advise against unsupervised use of St John's wort. Adjust the dose if the herb is started or stopped.
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 Dronabinol
- Cefotetan + Dronabinol Contraindicated
- Disulfiram + Dronabinol Contraindicated
- Dronabinol + Midazolam intranasal Major
- Dronabinol + Zuranolone Major
- Amobarbital + Dronabinol Moderate
- Apalutamide + Dronabinol Moderate
Frequently asked questions
Can I take Dronabinol with St john's wort?
MediHelp rates the interaction as moderate. Dronabinol 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 may lower dronabinol concentrations, reducing efficacy. Both agents also affect mood and CNS function, so unpredictable effects are possible.
How serious is the interaction between Dronabinol 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: Monitor the clinical response to dronabinol and advise against unsupervised use of St John's wort. Adjust the dose if the herb is started or stopped.
What other medicines interact with Dronabinol?
MediHelp also lists interactions of Dronabinol with, for example, Cefotetan, Disulfiram, Midazolam intranasal. The full list is on the Dronabinol page.
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