Drug interactions
Saxagliptin + St john's wort
Severity: Moderate
Saxagliptin 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 CYP3A4 and P-gp and may lower saxagliptin exposure. Because the active metabolite is formed by the same pathway, the net loss of effect is probably modest, but glycemic control could be affected.
What this interaction means in plain words
Saxagliptin 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 CYP3A4/5 and possibly P-gp by hyperforin increases saxagliptin clearance.
What to do
Monitor blood glucose when St John's wort is started or stopped, and advise patients to avoid it if control worsens.
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 Saxagliptin
- Albiglutide + Saxagliptin Moderate
- Amlodipine-benazepril + Saxagliptin Moderate
- Aripiprazole + Saxagliptin Moderate
- Asenapine + Saxagliptin Moderate
- Atazanavir + Saxagliptin Moderate
- Benazepril + Saxagliptin Moderate
Frequently asked questions
Can I take Saxagliptin with St john's wort?
MediHelp rates the interaction as moderate. Saxagliptin 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 CYP3A4 and P-gp and may lower saxagliptin exposure. Because the active metabolite is formed by the same pathway, the net loss of effect is probably modest, but glycemic control could be affected.
How serious is the interaction between Saxagliptin 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 blood glucose when St John's wort is started or stopped, and advise patients to avoid it if control worsens.
What other medicines interact with Saxagliptin?
MediHelp also lists interactions of Saxagliptin with, for example, Albiglutide, Amlodipine-benazepril, Aripiprazole. The full list is on the Saxagliptin page.
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