NutriStack
Diazepam and St. John's Wort, a conflict.
St. John's Wort induces CYP3A4 and CYP2C19, both of which metabolize diazepam. This can reduce diazepam levels, causing breakthrough anxiety or seizures in epilepsy patients.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Diazepam and St. John's Wort
- Pair type
- Conflict
- Evidence (highest tier)
- Strong
- Source citations
- 1 source
- Stack Score effect
- −10 to your Stack Score (per scored conflict row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Conflict · Strong evidence
Conflict
What is happening. St. John's Wort induces CYP3A4 and CYP2C19, both of which metabolize diazepam. This can reduce diazepam levels, causing breakthrough anxiety or seizures in epilepsy patients.
Mechanism. Diazepam is metabolized by CYP3A4 and CYP2C19 to active metabolites. SJW induces both enzymes, accelerating diazepam clearance and reducing therapeutic levels.
Recommendation. Avoid combining. Abrupt reduction in diazepam levels can cause withdrawal symptoms or seizures.
Stack Score
How this pair moves the number.
Effect on the composite score
If both Diazepam and St. John's Wort are in the same stack, this pair applies −10 to your Stack Score (per scored conflict row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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