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Drug interactions

St john's wort + Vinblastine

Severity: Moderate

St john's wort and Vinblastine: 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-glycoprotein and may lower vinblastine concentrations. This could reduce the effectiveness of chemotherapy.

What this interaction means in plain words

St john's wort and Vinblastine 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.

Evidence level: Moderate

Why it happens

Induction of CYP3A4 and P-glycoprotein by hyperforin increases vinblastine metabolism and efflux.

What to do

Advise patients to avoid St John's wort during vinblastine therapy. Allow for persistence of induction after stopping the herb.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take St john's wort with Vinblastine?

MediHelp rates the interaction as moderate. St john's wort and Vinblastine 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-glycoprotein and may lower vinblastine concentrations. This could reduce the effectiveness of chemotherapy.

How serious is the interaction between St john's wort and Vinblastine?

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 patients to avoid St John's wort during vinblastine therapy. Allow for persistence of induction after stopping the herb.

What other medicines interact with Vinblastine?

MediHelp also lists interactions of Vinblastine with, for example, Adenovirus types 4 and 7 live, Apalutamide, Atazanavir. The full list is on the Vinblastine page.

Full monographs, dosing and an interaction checker in the MediHelp app

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