Drug interactions
Pantoprazole + St john's wort
Severity: Moderate
Pantoprazole 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 CYP2C19 and CYP3A4 and may lower pantoprazole concentrations. Acid suppression may be reduced, with loss of symptom control or healing.
What this interaction means in plain words
Pantoprazole 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 CYP2C19 and CYP3A4 increases the metabolic clearance of pantoprazole.
What to do
Monitor for reduced response and consider stopping the herbal product or increasing the pantoprazole dose.
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 Pantoprazole
- Pantoprazole + Rilpivirine Contraindicated
- Acalabrutinib + Pantoprazole Major
- Atazanavir + Pantoprazole Major
- Dacomitinib + Pantoprazole Major
- Dasatinib + Pantoprazole Major
- Erlotinib + Pantoprazole Major
Frequently asked questions
Can I take Pantoprazole with St john's wort?
MediHelp rates the interaction as moderate. Pantoprazole 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 CYP2C19 and CYP3A4 and may lower pantoprazole concentrations. Acid suppression may be reduced, with loss of symptom control or healing.
How serious is the interaction between Pantoprazole 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: Monitor for reduced response and consider stopping the herbal product or increasing the pantoprazole dose.
What other medicines interact with Pantoprazole?
MediHelp also lists interactions of Pantoprazole with, for example, Rilpivirine, Acalabrutinib, Atazanavir. The full list is on the Pantoprazole page.
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