Drug interactions
Methylprednisolone + St john's wort
Severity: Moderate
Methylprednisolone 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 P-glycoprotein, which may lower methylprednisolone concentrations. Reduced corticosteroid effect can lead to loss of disease control.
What this interaction means in plain words
Methylprednisolone 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
Induction of CYP3A4 by hyperforin increases methylprednisolone metabolism.
What to do
Advise patients to avoid St John's wort, or monitor clinical response and increase the methylprednisolone dose if needed. Reassess dosing if the herb is 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 Methylprednisolone
- Bcg vaccine live + Methylprednisolone Contraindicated
- Measles mumps and rubella vaccine live + Methylprednisolone Contraindicated
- Measles mumps rubella and varicella vaccine live + Methylprednisolone Contraindicated
- Measles vaccine + Methylprednisolone Contraindicated
- Methylprednisolone + Mifepristone Contraindicated
- Methylprednisolone + Rubella vaccine Contraindicated
Frequently asked questions
Can I take Methylprednisolone with St john's wort?
MediHelp rates the interaction as moderate. Methylprednisolone 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 P-glycoprotein, which may lower methylprednisolone concentrations. Reduced corticosteroid effect can lead to loss of disease control.
How serious is the interaction between Methylprednisolone 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 patients to avoid St John's wort, or monitor clinical response and increase the methylprednisolone dose if needed. Reassess dosing if the herb is stopped.
What other medicines interact with Methylprednisolone?
MediHelp also lists interactions of Methylprednisolone with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Methylprednisolone page.
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