Drug interactions
Nateglinide + St john's wort
Severity: Moderate
Nateglinide 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 CYP2C9 and may lower nateglinide concentrations. Reduced glucose-lowering effect may result, and rebound hypoglycemia can occur if the herb is stopped.
What this interaction means in plain words
Nateglinide 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 CYP2C9 and CYP3A4 increases nateglinide clearance.
What to do
Avoid the combination where possible; if used, monitor blood glucose and adjust nateglinide when the herb is started or 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 Nateglinide
- Albiglutide + Nateglinide Moderate
- Alogliptin-metformin + Nateglinide Moderate
- Alogliptin-pioglitazone + Nateglinide Moderate
- Alogliptin + Nateglinide Moderate
- Alpelisib + Nateglinide Moderate
- Amiodarone + Nateglinide Moderate
Frequently asked questions
Can I take Nateglinide with St john's wort?
MediHelp rates the interaction as moderate. Nateglinide 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 CYP2C9 and may lower nateglinide concentrations. Reduced glucose-lowering effect may result, and rebound hypoglycemia can occur if the herb is stopped.
How serious is the interaction between Nateglinide 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: Avoid the combination where possible; if used, monitor blood glucose and adjust nateglinide when the herb is started or stopped.
What other medicines interact with Nateglinide?
MediHelp also lists interactions of Nateglinide with, for example, Albiglutide, Alogliptin-metformin, Alogliptin-pioglitazone. The full list is on the Nateglinide page.
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