Drug interactions
Propafenone + St john's wort
Severity: Moderate
Propafenone 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 drug-metabolizing enzymes and may lower propafenone concentrations, risking loss of arrhythmia control.
What this interaction means in plain words
Propafenone 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 St John's wort increases propafenone clearance.
What to do
Advise avoiding St John's wort, or monitor rhythm and adjust propafenone dose. Reassess 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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Frequently asked questions
Can I take Propafenone with St john's wort?
MediHelp rates the interaction as moderate. Propafenone 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 drug-metabolizing enzymes and may lower propafenone concentrations, risking loss of arrhythmia control.
How serious is the interaction between Propafenone 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 rhythm and adjust propafenone dose. Reassess when the herb is stopped.
What other medicines interact with Propafenone?
MediHelp also lists interactions of Propafenone with, for example, Dofetilide, Dronedarone, Nilotinib. The full list is on the Propafenone page.
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