Supplement × Prescription·contraindicated·Moderate evidence
St. John's Wort has serotonergic activity and can interact unpredictably with centrally acting analgesics, increasing serotonin syndrome concern.
Every entry follows the same shape: what is happening, the mechanism, and the recommendation.
What is happening. St. John's Wort has serotonergic activity and can interact unpredictably with centrally acting analgesics, increasing serotonin syndrome concern.
Mechanism. Serotonergic activity plus enzyme/transporter induction may alter response and toxicity risk.
Recommendation. Avoid combining with tapentadol; use clinician-guided depression or sleep treatments instead.
Effect on the composite score
If both St. John's Wort and Tapentadol are in the same stack, this pair applies −25 to your Stack Score (per scored contraindication 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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