Drug interactions
Sofosbuvir + St john's wort
Severity: Major
Sofosbuvir and St john's wort: major 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 P-gp and is expected to lower sofosbuvir exposure. This may lead to hepatitis C treatment failure.
What this interaction means in plain words
Sofosbuvir and St john's wort can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Induction of intestinal P-gp decreases sofosbuvir absorption.
What to do
Avoid combination; stop the herbal product before starting sofosbuvir.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Sofosbuvir
Frequently asked questions
Can I take Sofosbuvir with St john's wort?
MediHelp rates the interaction as major. Sofosbuvir and St john's wort can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. St John's wort induces P-gp and is expected to lower sofosbuvir exposure. This may lead to hepatitis C treatment failure.
How serious is the interaction between Sofosbuvir and St john's wort?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combination; stop the herbal product before starting sofosbuvir.
What other medicines interact with Sofosbuvir?
MediHelp also lists interactions of Sofosbuvir with, for example, Amiodarone, Apalutamide, Carbamazepine. The full list is on the Sofosbuvir page.
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