Drug interactions
Edoxaban + St john's wort
Severity: Major
Edoxaban 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 P-glycoprotein and may lower edoxaban concentrations, reducing anticoagulant protection. This may lead to thromboembolic events.
What this interaction means in plain words
Edoxaban 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
Induction of intestinal and hepatic P-gp reduces edoxaban absorption and increases its elimination.
What to do
Avoid the combination, as edoxaban labeling advises against potent P-gp inducers. Stop St John's wort or use another anticoagulant.
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 Edoxaban
- Apixaban + Edoxaban Contraindicated
- Defibrotide + Edoxaban Contraindicated
- Edoxaban + Ketorolac Contraindicated
- Abciximab + Edoxaban Major
- Acetylsalicylic acid + Edoxaban Major
- Argatroban + Edoxaban Major
Frequently asked questions
Can I take Edoxaban with St john's wort?
MediHelp rates the interaction as major. Edoxaban 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 P-glycoprotein and may lower edoxaban concentrations, reducing anticoagulant protection. This may lead to thromboembolic events.
How serious is the interaction between Edoxaban 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: Avoid the combination, as edoxaban labeling advises against potent P-gp inducers. Stop St John's wort or use another anticoagulant.
What other medicines interact with Edoxaban?
MediHelp also lists interactions of Edoxaban with, for example, Apixaban, Defibrotide, Ketorolac. The full list is on the Edoxaban page.
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