Drug interactions
Nifedipine + St john's wort
Severity: Moderate
Nifedipine 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, lowering nifedipine concentrations and potentially reducing blood pressure or angina control. Loss of effect may occur within days to weeks, and stopping the herb can lead to a rebound rise in nifedipine levels.
What this interaction means in plain words
Nifedipine 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 (and P-gp) by hyperforin increases nifedipine clearance.
What to do
Avoid the combination where possible and monitor blood pressure and symptoms. If the herb is stopped, reassess nifedipine dose for increased exposure.
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 Nifedipine
Frequently asked questions
Can I take Nifedipine with St john's wort?
MediHelp rates the interaction as moderate. Nifedipine 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, lowering nifedipine concentrations and potentially reducing blood pressure or angina control. Loss of effect may occur within days to weeks, and stopping the herb can lead to a rebound rise in nifedipine levels.
How serious is the interaction between Nifedipine 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 and monitor blood pressure and symptoms. If the herb is stopped, reassess nifedipine dose for increased exposure.
What other medicines interact with Nifedipine?
MediHelp also lists interactions of Nifedipine with, for example, Amifostine, Amlodipine-benazepril, Apalutamide. The full list is on the Nifedipine page.
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