Drug interactions
Sorafenib + St john's wort
Severity: Major
Sorafenib 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 may reduce sorafenib concentrations and compromise efficacy. Labeling advises avoiding strong CYP3A4 inducers.
What this interaction means in plain words
Sorafenib 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 CYP3A4 and P-glycoprotein increases sorafenib clearance.
What to do
Avoid St John's wort during sorafenib therapy and counsel patients about herbal products.
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 Sorafenib
Frequently asked questions
Can I take Sorafenib with St john's wort?
MediHelp rates the interaction as major. Sorafenib 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 may reduce sorafenib concentrations and compromise efficacy. Labeling advises avoiding strong CYP3A4 inducers.
How serious is the interaction between Sorafenib 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 St John's wort during sorafenib therapy and counsel patients about herbal products.
What other medicines interact with Sorafenib?
MediHelp also lists interactions of Sorafenib with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Sorafenib page.
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