Selected Antineoplastic Systemic Enzyme Inhibitors/St. John's Wort Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

St. John's wort can speed up how quickly your liver processes your cancer medicine.

What might happen:

The amount of cancer medicine in your blood may decrease and it may not work as well against your cancer.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to change the dose of your cancer medicine while you are taking St. John's wort or your doctor may want you to stop taking St. John's wort. Let your healthcare professional know if you stop taking St. John's wort.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Velcade (bortezomib) US prescribing information. Mellennium Pharmaceuticals, Inc. October, 2021.
  • 2.Bosulif (bosutinib) US prescribing information. Pfizer Inc. September, 2023.
  • 3.Zykadia (ceritinib) US prescribing information. Novartis Pharmaceuticals Corporation August, 2021.
  • 4.Xalkori (crizotinib) US prescribing information. Pfizer Inc. September, 2023.
  • 5.Sprycel (dasatinib) US prescribing information. Bristol-Myers Squibb Company February, 2023.
  • 6.Tarceva (erlotinib) US prescribing information. Genentech, Inc. October, 2016.
  • 7.Iressa (gefitinib tablets) US prescribing information. AstraZeneca Pharmaceuticals LP April 7, 2004.
  • 8.Zydelig (idelalisib) US prescribing information. Gilead Sciences, Inc. October, 2020.
  • 9.Gleevec (imatinib mesylate) US prescribing information. Novartis Pharmaceuticals Corporation August, 2022.
  • 10.Tykerb (lapatinib) US prescribing information. GlaxoSmithKline December, 2018.
  • 11.Votrient (pazopanib) US prescribing information. GlaxoSmithKline August, 2020.
  • 12.Nexavar (sorafenib) US prescribing information. Bayer Pharmaceuticals Corporation July, 2020.
  • 13.Caprelsa (vandetanib) US prescribing information. AstraZeneca Pharmaceuticals LP October, 2018.
  • 14.Bolton AE, Peng B, Hubert M, Krebs-Brown A, Capdeville R, Keller U, Seiberling M. Effect of rifampicin on the pharmacokinetics of imatinib mesylate (Gleevec, STI571) in healthy subjects. Cancer Chemother Pharmacol 2004 Feb;53(2):102-6.
  • 15.Imbruvica (ibrutinib) US Prescribing information. Pharmacyclics, Inc. August, 2022.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.