Drug Interactions Corner

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St. John’s Wort Interacts with Imatinib Through 3A4 Induction

KEY POINT

St. John’s wort, through its induction of the cytochrome P450 3A4 enzymes, reduces serum concentrations of imatinib (Gleevec—Novartis). Concomitant use of the dietary supplement and antineoplastic medication should be avoided.

SOURCES

Smith P. The influence of St. John’s wort on the pharmacokinetics and protein binding of imatinib mesylate. Pharmacotherapy. 2004;24:1508–14.