Drug interactions
Fludrocortisone + St john's wort
Severity: Moderate
Fludrocortisone 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 reduce fludrocortisone exposure, with a potential loss of mineralocorticoid effect in patients who depend on replacement. Clinical data for this specific pair are limited.
What this interaction means in plain words
Fludrocortisone 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, accelerating fludrocortisone clearance.
What to do
Advise against St John's wort in adrenal insufficiency. If it is used, monitor blood pressure, sodium and potassium and adjust the fludrocortisone dose.
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 Fludrocortisone
Frequently asked questions
Can I take Fludrocortisone with St john's wort?
MediHelp rates the interaction as moderate. Fludrocortisone 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 reduce fludrocortisone exposure, with a potential loss of mineralocorticoid effect in patients who depend on replacement. Clinical data for this specific pair are limited.
How serious is the interaction between Fludrocortisone 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 against St John's wort in adrenal insufficiency. If it is used, monitor blood pressure, sodium and potassium and adjust the fludrocortisone dose.
What other medicines interact with Fludrocortisone?
MediHelp also lists interactions of Fludrocortisone with, for example, Mifepristone, Aldesleukin, Amphotericin b. The full list is on the Fludrocortisone page.
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