Drug interactions
Paliperidone + St john's wort
Severity: Moderate
Paliperidone 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 P-glycoprotein and CYP3A4 and may lower paliperidone exposure, risking reduced antipsychotic effect. It may also add serotonergic or other effects.
What this interaction means in plain words
Paliperidone 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 P-glycoprotein and CYP3A4 by hyperforin, increasing paliperidone clearance.
What to do
Advise avoiding St John's wort, or monitor for relapse and consider paliperidone dose adjustment. Review dosing 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 Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
Frequently asked questions
Can I take Paliperidone with St john's wort?
MediHelp rates the interaction as moderate. Paliperidone 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 P-glycoprotein and CYP3A4 and may lower paliperidone exposure, risking reduced antipsychotic effect. It may also add serotonergic or other effects.
How serious is the interaction between Paliperidone 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 avoiding St John's wort, or monitor for relapse and consider paliperidone dose adjustment. Review dosing when the herb is stopped.
What other medicines interact with Paliperidone?
MediHelp also lists interactions of Paliperidone with, for example, Ibutilide, Pimozide, Vandetanib. The full list is on the Paliperidone page.
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