Cyclosporine and St Johns Wort: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Cyclosporine and St Johns Wort unless specifically directed by your doctor.
How Cyclosporine interacts with St Johns Wort
St John's wort induces CYP3A4 and P-glycoprotein, increasing cyclosporine metabolism and efflux. Cyclosporine concentrations can fall, risking transplant rejection.
What you should do
Contraindicate or strongly avoid coadministration. Check cyclosporine levels if exposure has occurred and manage urgently.
Key facts
Severity
Major — avoid combination
Mechanism
St John's wort induces CYP3A4 and P-glycoprotein, increasing cyclosporine metabolism and efflux. Cyclosporine concentrat...
Action
Contraindicate or strongly avoid coadministration. Check cyclosporine levels if exposure has occurred and manage urgentl...
Frequently asked questions
Can I take Cyclosporine and St Johns Wort together?
No — this combination should generally be avoided. Contraindicate or strongly avoid coadministration. Check cyclosporine levels if exposure has occurred and manage urgently.
What is the severity of this interaction?
The interaction between Cyclosporine and St Johns Wort is classified as Major — avoid combination. St John's wort induces CYP3A4 and P-glycoprotein, increasing cyclosporine metabolism and efflux. Cyclosporine concentrations can fall, risking transplant rejection.
What should I do if I'm prescribed both?
Contraindicate or strongly avoid coadministration. Check cyclosporine levels if exposure has occurred and manage urgently. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.