Drug interactions
Medroxyprogesterone + St john's wort
Severity: Major
Medroxyprogesterone 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 CYP3A4 and may lower medroxyprogesterone exposure. This can cause breakthrough bleeding and reduced contraceptive reliability.
What this interaction means in plain words
Medroxyprogesterone 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 CYP3A4 and P-glycoprotein by hyperforin increases progestin clearance.
What to do
Avoid the combination where contraception or endometrial protection is needed, or add a non-hormonal contraceptive method. Counsel that induction persists for about two weeks after stopping the herb.
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 Medroxyprogesterone
Frequently asked questions
Can I take Medroxyprogesterone with St john's wort?
MediHelp rates the interaction as major. Medroxyprogesterone 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 may lower medroxyprogesterone exposure. This can cause breakthrough bleeding and reduced contraceptive reliability.
How serious is the interaction between Medroxyprogesterone 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 where contraception or endometrial protection is needed, or add a non-hormonal contraceptive method. Counsel that induction persists for about two weeks after stopping the herb.
What other medicines interact with Medroxyprogesterone?
MediHelp also lists interactions of Medroxyprogesterone with, for example, Bosentan, Brigatinib, Eslicarbazepine. The full list is on the Medroxyprogesterone page.
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