Drug interactions
St john's wort + Zolpidem
Severity: Moderate
St john's wort and Zolpidem: 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 may reduce zolpidem concentrations. This can lessen hypnotic efficacy. Serotonergic or additive CNS effects are not a major concern here.
What this interaction means in plain words
St john's wort and Zolpidem 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
St John's wort induces CYP3A4, increasing zolpidem clearance.
What to do
Monitor for reduced hypnotic effect and discourage concurrent use. If the herb is stopped, watch for increased zolpidem effects as induction wanes.
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 Zolpidem
Frequently asked questions
Can I take St john's wort with Zolpidem?
MediHelp rates the interaction as moderate. St john's wort and Zolpidem 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 may reduce zolpidem concentrations. This can lessen hypnotic efficacy. Serotonergic or additive CNS effects are not a major concern here.
How serious is the interaction between St john's wort and Zolpidem?
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 for reduced hypnotic effect and discourage concurrent use. If the herb is stopped, watch for increased zolpidem effects as induction wanes.
What other medicines interact with Zolpidem?
MediHelp also lists interactions of Zolpidem with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Benzhydrocodone / acetaminophen. The full list is on the Zolpidem page.
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