Drug interactions
Ixazomib + St john's wort
Severity: Major
Ixazomib 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 can lower ixazomib exposure. This may lead to reduced anti-myeloma activity.
What this interaction means in plain words
Ixazomib 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 in St John's wort activates PXR, inducing CYP3A4 and increasing ixazomib clearance.
What to do
Advise patients to stop St John's wort before starting ixazomib and avoid it during therapy.
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 Ixazomib
- Apalutamide + Ixazomib Major
- Carbamazepine + Ixazomib Major
- Dabrafenib + Ixazomib Major
- Enzalutamide + Ixazomib Major
- Etrasimod + Ixazomib Major
- Fosphenytoin + Ixazomib Major
Frequently asked questions
Can I take Ixazomib with St john's wort?
MediHelp rates the interaction as major. Ixazomib 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 can lower ixazomib exposure. This may lead to reduced anti-myeloma activity.
How serious is the interaction between Ixazomib 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 stop St John's wort before starting ixazomib and avoid it during therapy.
What other medicines interact with Ixazomib?
MediHelp also lists interactions of Ixazomib with, for example, Apalutamide, Carbamazepine, Dabrafenib. The full list is on the Ixazomib page.
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