Drug interactions
Rabeprazole + St john's wort
Severity: Minor
Rabeprazole and St john's wort: minor 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 CYP2C19 and may lower rabeprazole exposure. The effect is likely smaller for rabeprazole than for other PPIs because of its non-enzymatic clearance, but it could reduce acid suppression.
What this interaction means in plain words
Rabeprazole and St john's wort have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
St John's wort induces CYP2C19 and CYP3A4, which are minor routes of rabeprazole metabolism.
What to do
Monitor symptom control and consider discouraging the herbal product or increasing the PPI dose if acid suppression is inadequate.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Rabeprazole
- Rabeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Rabeprazole Major
- Atazanavir + Rabeprazole Major
- Dacomitinib + Rabeprazole Major
- Dasatinib + Rabeprazole Major
- Erlotinib + Rabeprazole Major
Frequently asked questions
Can I take Rabeprazole with St john's wort?
MediHelp rates the interaction as minor. Rabeprazole and St john's wort have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. St John's wort induces CYP3A4 and CYP2C19 and may lower rabeprazole exposure. The effect is likely smaller for rabeprazole than for other PPIs because of its non-enzymatic clearance, but it could reduce acid suppression.
How serious is the interaction between Rabeprazole and St john's wort?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor symptom control and consider discouraging the herbal product or increasing the PPI dose if acid suppression is inadequate.
What other medicines interact with Rabeprazole?
MediHelp also lists interactions of Rabeprazole with, for example, Rilpivirine, Acalabrutinib, Atazanavir. The full list is on the Rabeprazole page.
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