The short answer
Do not add St John’s wort to cariprazine without prescriber review. Exact labeling advises against CYP3A4-inducing combinations, but a simple reduction in absorption is not established.
What this answer covers
Oral Hypericum perforatum with cariprazine hydrochloride capsules.
- Supplement or preparation
- Hypericum perforatum
- Medication ingredient
- cariprazine
The labels support avoiding unsupervised co-use
The UK label specifically includes St John’s wort among contraindicated inducers. The US label does not recommend cariprazine with CYP3A4 inducers.
The direction cannot be simplified
CYP3A4 both forms and clears active cariprazine metabolites. The US label says the net inducer effect has not been evaluated and is unclear, so reduced absorption is not a measured conclusion.
Extract findings do not settle this medicine
St John’s wort probe studies differ by extract, including a low-hyperforin preparation with little effect. They cannot establish a safe cariprazine-herb regimen.
Discuss starting and stopping
Do not change cariprazine to counter the herb. Its prolonged active-metabolite exposure makes a short supplement gap an untested solution.
Evidence and practical considerations
Side effects & toxicity
Conditional avoidance/review guidance; claimed reduced absorption or effectiveness remains insufficiently demonstrated for this exact pair.
- Exact scope
- Oral Hypericum perforatum with cariprazine hydrochloride capsules. with Exact cariprazine hydrochloride capsules. Exact RxNorm IN1667655; hydrochloride oral capsules. Active DCAR and DDCAR metabolites and long equilibration matter.
- Medication form and route
- oral
- Timing or duration
- Source-specific single-dose, repeated-dose and observational exposures distinguished.
What remains uncertain
- No direct cariprazine-herb study; US label explicitly says inducer net effect on parent and active metabolites is unclear.
Factors that may matter: preparation and plant part; clinical indication; dose; other medicines; baseline alertness.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed cariprazine.
Somnolence/falls precautions; CYP3A4 inhibitors raise exposure, inducer net effect unstudied and unclear; long-lived active metabolites.
How this applies: Exact RxNorm IN1667655; hydrochloride oral capsules. Active DCAR and DDCAR metabolites and long equilibration matter.
No supplement-specific event rate, universal timing rule or untested route/preparation equivalence.
Source 2: official product label
medicines.org.uk · Source check Sep 10, 2026
Population: People prescribed oral cariprazine hydrochloride capsules.
Advises avoiding grapefruit juice; contraindicates strong/moderate CYP3A4 inducers including St John’s wort.
How this applies: Exact oral ingredient guidance with geographic and evidence boundaries.
UK labeling differs from US inhibitor instructions. No direct grapefruit trial or measured herb interaction; US label says inducer net effect remains unclear.
Source 3: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Twelve healthy volunteers in an open-label fixed-order crossover.
Alprazolam exposure fell about one-half and clearance increased; elimination half-life shortened.
How this applies: Preparation-specific original evidence; no untested antidepressant or route transfer.
Single extract and short exposure, healthy volunteers; no anxiety-treatment failure endpoint. Does not imply reduced gut absorption or transfer to predominantly conjugated benzodiazepines.
Source 4: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Healthy participants in randomized placebo-controlled studies.
Changes in probe exposures were small and judged clinically irrelevant; hyperforin levels were below quantification.
How this applies: Preparation-specific original evidence; no untested antidepressant or route transfer.
Preparation-specific result, not permission to assume all retail products are low-hyperforin or all doses safe.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Research summary published | |
| Article prepared | |
| Current exact available claims adjudicated using original captures and explicit identity and comparator limits. |
Article revision: 22d9df91e724308d
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.