| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Rilpivirine (IM) St. John's Wort (Hypericum perforatum) | Red: Avoid combination | Do not coadminister: Potential for reduced levels of rilpivirine | Decreased rilpivirine effects |
Use alternative agents |
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| Lenacapavir St. John's Wort | Red: Avoid combination | Do not coadminister: reduced levels of lenacapavir | Potential loss of antiviral efficacy |
Contraindicated. Use alternative agents. |
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| Ritonavir St. John's Wort (Hypericum perforatum) 1083 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of ritonavir | Decreased ritonavir effects |
Not studied (may decrease ritonavir levels) |
Not studied |
Contraindicated. Use alternative agents. |
|
| Darunavir St. John's Wort (Hypericum perforatum) 953 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of darunavir | Potential loss of antiviral efficacy |
Contraindicated. Use alternative agents. |
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| Atazanavir St. John's Wort (Hypericum perforatum) 832 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of atazanavir | Potential loss of antiretroviral efficacy |
Contraindicated. Use alternative agents. |
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| Tenofovir alafenamide St. John's Wort (Hypericum perforatum) 724 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of TAF | Potential decrease in antiretroviral efficacy |
Not studied |
Not studied |
Contraindicated. Use alternative agents. |
|
| Rilpivirine St. John's Wort (Hypericum perforatum) 660 | Red: Avoid combination | Contraindicated | |||||
| Nevirapine St. John's Wort (Hypericum perforatum) 608 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of NVP | loss of virologic response |
Not studied |
Contraindicated. Use alternative agents |
||
| Etravirine St. John's Wort (Hypericum perforatum) 543 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of ETR | loss of virologic response |
Not studied |
Not studied |
Contraindicated. Use alternative agents. |
|
| Efavirenz St. John's Wort (Hypericum perforatum) 441 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of efavirenz | Decreased efavirenz effects |
Not studied (may decrease efavirenz levels) |
Not studied |
Contraindicated. Use alternative agents. |
|
| Doravirine St. John's Wort (Hypericum perforatum) 353 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of doravirine | Potential decrease in antiretroviral efficacy |
Contraindicated. Use alternative agents. If discontinuing St. John's Wort, a minimum 4 week cessation period is recommended prior to initiating doravirine. |
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| Cabotegravir St. John's Wort (Hypericum perforatum) 341 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of CAB | Potential decrease in antiretroviral efficacy |
Not studied |
Not studied |
Contraindicated. Use alternative agents. |
|
| Elvitegravir St. John's Wort (Hypericum perforatum) 219 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of elvitegravir | Potential decrease in antiretroviral efficacy |
Contraindicated. Use alternative agents. |
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| Dolutegravir St. John's Wort (Hypericum perforatum) 120 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of dolutegravir | Potential decrease in antiretroviral efficacy |
Not studied (may decreased dolutegravir levels) |
Not studied |
Contraindicated. Use alternative agents. |
|
| Bictegravir St. John's Wort (Hypericum perforatum) 76 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of BIC and TAF | Potential decrease in antiretroviral efficacy |
Contraindicated. Use alternative agents. |
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| Maraviroc St. John's Wort (Hypericum perforatum) 60 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of maraviroc | Potential decrease in antiretroviral efficacy |
Use alternative agents |
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| Fostemsavir St. John's Wort (Hypericum perforatum) 22 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of temsavir | Potential decrease in antiretroviral efficacy |
Contraindicated. Use alternative agents. |
