Supplement × Prescription·a conflict·Moderate evidence
St. John's Wort can induce CYP3A4 and may reduce roflumilast exposure, potentially decreasing COPD exacerbation prevention.
Every entry follows the same shape: what is happening, the mechanism, and the recommendation.
What is happening. St. John's Wort can induce CYP3A4 and may reduce roflumilast exposure, potentially decreasing COPD exacerbation prevention.
Mechanism. CYP3A4 induction can lower roflumilast and active metabolite exposure.
Recommendation. Avoid St. John's Wort unless the prescriber specifically approves and monitors clinical response.
Effect on the composite score
If both Roflumilast 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 at /methodology/stack-score.
Every claim on this page is cited. PMIDs link straight to PubMed.
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NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.
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