Does St Johns Wort Interact with Isotretinoin?
St Johns Wort and Isotretinoin have a major drug interaction according to U.S. FDA drug labeling data. Possible interaction with hormonal contraceptives; reports of breakthrough bleeding and pregnancies in users of combined hormonal contraceptives who also used St. John's Wort. The mechanism involves may decrease effectiveness of hormonal contraceptives. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.
- Severity
- Major
- Isotretinoin Class
- Retinoid
- Management
- Close medical supervision required
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between St Johns Wort and Isotretinoin occurs because may decrease effectiveness of hormonal contraceptives. Clinically, this means possible interaction with hormonal contraceptives; reports of breakthrough bleeding and pregnancies in users of combined hormonal contraceptives who also used st. john's wort. This is classified as a major interaction, meaning it could cause serious harm if not properly managed. Your healthcare provider may need to adjust dosages, substitute one medication, or increase monitoring frequency.
What To Tell Your Doctor or Pharmacist
If you are taking St Johns Wort and your doctor is considering prescribing Isotretinoin (or vice versa), make sure to:
- Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
- Ask whether the benefits of combining these medications outweigh the risks for your specific situation
- Ask what symptoms to watch for that would indicate the interaction is causing problems
- Ask how frequently you should be monitored while these are co-prescribed
- Ask whether any dosage adjustments are needed
- Never stop or change either medication without first consulting your healthcare provider