Supplement × Prescription·a conflict·Emerging evidence
St. John's Wort can induce CYP3A4 and may lower exposure to CYP3A4 substrates, potentially making controller response less predictable.
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 lower exposure to CYP3A4 substrates, potentially making controller response less predictable.
Mechanism. CYP3A4 induction may reduce systemic and local exposure of susceptible drugs, though inhaled clinical impact is uncertain.
Recommendation. Avoid unsupervised St. John's Wort in patients relying on stable inhaled controller therapy; discuss mood treatment alternatives with a clinician.
Effect on the composite score
If both Salmeterol/Fluticasone 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.
Check your full routine
Drop your supplements and prescriptions into NutriStack and it runs every pair at once: every interaction, synergy, timing rule, and contraindication, each linked to its primary source.
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.
NutriStack