MajormTOR kinase inhibitor – immunosuppressant and antineoplastic×Antidepressants. Other antidepressants of herbal origin
Updated · Methodology
Mechanism
St. John's wort is a potent inducer of the CYP3A4 enzyme (and of CYP2C9 and P-glycoprotein). After 1–2 weeks it speeds up the breakdown of Everolimus and lowers its blood level, weakening its effect.
Symptoms
Reduced everolimus levels, loss of immunosuppressant or antitumor effect, risk of transplant rejection.
Management
Avoid the combination. Monitor everolimus levels and stop the herb.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- British Journal of Pharmacology: Clinical relevance of St. John's wort drug interactions revisited (2020)– Nicolussi S, et al. Br J Pharmacol. 2020;177(6):1212-1226.
- AEMPS: Ficha técnica: Everolimus (nº registro 84203), sección 4.5 (2024)– AEMPS, CIMA, nº registro 84203, sección 4.5