Drug interactions
Nimodipine + St john's wort
Severity: Moderate
Nimodipine 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 can reduce nimodipine levels and weaken its clinical effect. The effect varies with the hyperforin content of the product.
What this interaction means in plain words
Nimodipine 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
Hyperforin-mediated induction of CYP3A4 and P-gp increases nimodipine clearance and reduces bioavailability.
What to do
Advise stopping St John's wort before nimodipine therapy; if continued, monitor blood pressure and therapeutic response and readjust the nimodipine dose when 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 Nimodipine
- Apalutamide + Nimodipine Major
- Carbamazepine + Nimodipine Major
- Ceritinib + Nimodipine Major
- Clarithromycin + Nimodipine Major
- Cobicistat + Nimodipine Major
- Darunavir + Nimodipine Major
Frequently asked questions
Can I take Nimodipine with St john's wort?
MediHelp rates the interaction as moderate. Nimodipine 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 can reduce nimodipine levels and weaken its clinical effect. The effect varies with the hyperforin content of the product.
How serious is the interaction between Nimodipine 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 stopping St John's wort before nimodipine therapy; if continued, monitor blood pressure and therapeutic response and readjust the nimodipine dose when the herb is stopped.
What other medicines interact with Nimodipine?
MediHelp also lists interactions of Nimodipine with, for example, Apalutamide, Carbamazepine, Ceritinib. The full list is on the Nimodipine page.
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