Drug interactions
Procarbazine + St john's wort
Severity: Contraindicated
Procarbazine and St john's wort: contraindicated 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 has serotonergic activity, and combined with an MAO inhibitor such as procarbazine it may precipitate serotonin syndrome. Features include agitation, hyperthermia, tremor and autonomic instability.
What this interaction means in plain words
Procarbazine and St john's wort are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Additive serotonergic effects from MAO inhibition and St John's wort reuptake inhibition.
What to do
Avoid the combination and stop St John's wort before starting procarbazine; allow at least 2 weeks after stopping an MAOI before using it. Counsel patients on herbal product use.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Procarbazine and St john's wort, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Procarbazine
- Adenovirus types 4 and 7 live + Procarbazine Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amoxapine + Procarbazine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Bcg vaccine live + Procarbazine Contraindicated
- Brimonidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Procarbazine with St john's wort?
MediHelp rates the interaction as contraindicated. Procarbazine and St john's wort are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. St John's wort has serotonergic activity, and combined with an MAO inhibitor such as procarbazine it may precipitate serotonin syndrome. Features include agitation, hyperthermia, tremor and autonomic instability.
How serious is the interaction between Procarbazine and St john's wort?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and stop St John's wort before starting procarbazine; allow at least 2 weeks after stopping an MAOI before using it. Counsel patients on herbal product use.
What other medicines interact with Procarbazine?
MediHelp also lists interactions of Procarbazine with, for example, Adenovirus types 4 and 7 live, Amitriptyline, Amoxapine. The full list is on the Procarbazine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
