The short answer
Do not add St. John’s wort to daridorexant without prescriber review. Current QUVIVIQ labeling directs avoidance of moderate or strong CYP3A4 inducers, which can lower drug exposure and reduce its effect.
What this answer covers
Hypericum perforatum products; hyperforin content and duration affect enzyme induction.
- Supplement or preparation
- Hypericum perforatum
- Medication ingredient
- daridorexant
The herb and pathway are identified
MedlinePlus specifically names St. John’s wort as interacting with daridorexant. Current US QUVIVIQ labeling directs avoiding moderate and strong CYP3A4 inducers because they can lower exposure and effectiveness.
What the human study measured
In healthy men, repeated efavirenz reduced daridorexant exposure. This establishes sensitivity to a moderate inducer, but efavirenz is not St. John’s wort. A separate famotidine arm lowered the peak without changing total exposure, illustrating why absorption and overall blood levels are distinct.
Study discussion does not replace current labeling
The efavirenz study authors proposed that moderate-inducer co-use could be acceptable based on lower-dose efficacy data. Current US labeling nevertheless directs avoidance. Human St. John’s wort probe studies show preparation-dependent induction; their numerical results are not an exact daridorexant prediction.
A timing gap is not an established fix
Review starting or stopping the herb with the prescriber and do not increase daridorexant yourself. Enzyme induction is not confined to simultaneous swallowing. No protective hour interval or exact herb-specific washout was established.
Evidence and practical considerations
Timing & monitoring
Current exact-drug labeling avoids moderate/strong CYP3A4 inducers, and federal exact-drug guidance names St John’s wort. Supports avoidance/review and potential reduced exposure/effectiveness, not proven reduced gut absorption or protective spacing. Exact herb-pair magnitude unknown; older efavirenz authors’ permissive discussion does not override current label.
- Exact scope
- Hypericum perforatum products; hyperforin content and duration affect enzyme induction. with Daridorexant2591497 IN; oral QUVIVIQ hydrochloride tablets.
- Medication form and route
- oral medication; oral supplement
What remains uncertain
- No unmeasured pair incidence, blanket class transfer or arbitrary spacing interval.
Factors that may matter: Preparation; Dose; Other medicines; Organ function.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed daridorexant
Avoid strong CYP3A4 inhibitors and moderate/strong inducers; moderate inhibitors limit dose25mg. CNS-depressant effects and next-day impairment, complex sleep behaviors.
How this applies: Exact daridorexant RxCUI 2591497 IN, with stated salt/formulation/route bridge.
No exact botanical extract PK trial or supplement-combination incidence; distinguish modeled strong-modifier effects from measured clinical data.
Source 2: Federal medication information
medlineplus.gov · Source check Sep 10, 2026
Population: People prescribed daridorexant
Specifically names St John’s wort as an interacting herbal product and directs discussion before starting it.
How this applies: Exact daridorexant and named Hypericum precaution.
Patient guidance, not an original herb-daridorexant PK study or quantified interaction.
Source 3: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 24 male subjects in randomized open-label study.
Famotidine lowered peak39% without changing AUC. Efavirenz lowered AUC61%, peak35%, half-life35%. Treatments well tolerated.
How this applies: 24 healthy males; no botanical. Authors proposed allowing moderate inducers based on efficacy extrapolation, but current US labeling directs avoidance. No direct herb clinical benefit endpoint.
24 healthy males; no botanical. Authors proposed allowing moderate inducers based on efficacy extrapolation, but current US labeling directs avoidance. No direct herb clinical benefit endpoint.
Source 4: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 12 healthy adults.
Short-term dosing had no measured CYP effect; repeated use reduced oral midazolam AUC more than IV AUC.
How this applies: Original source interpreted for daridorexant only within the stated preparation and endpoint limits.
Not a direct daridorexant combination trial; original preparation, dose and endpoint limits apply. No exact-pair adverse-event rate or protective spacing established.
Source 5: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 20 healthy men.
Small AUC decrease considered not clinically relevant by authors; no significant Cmax or half-life change.
How this applies: Original source interpreted for daridorexant only within the stated preparation and endpoint limits.
Not a direct daridorexant combination trial; original preparation, dose and endpoint limits apply. No exact-pair adverse-event rate or protective spacing established.
Research assessment: · Open full citations ↗
Absorption & effectiveness
Current exact-drug labeling avoids moderate/strong CYP3A4 inducers, and federal exact-drug guidance names St John’s wort. Supports avoidance/review and potential reduced exposure/effectiveness, not proven reduced gut absorption or protective spacing. Exact herb-pair magnitude unknown; older efavirenz authors’ permissive discussion does not override current label.
- Exact scope
- Hypericum perforatum products; hyperforin content and duration affect enzyme induction. with Daridorexant2591497 IN; oral QUVIVIQ hydrochloride tablets.
- Medication form and route
- oral medication; oral supplement
What remains uncertain
- No unmeasured pair incidence, blanket class transfer or arbitrary spacing interval.
Factors that may matter: Preparation; Dose; Other medicines; Organ function.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed daridorexant
Avoid strong CYP3A4 inhibitors and moderate/strong inducers; moderate inhibitors limit dose25mg. CNS-depressant effects and next-day impairment, complex sleep behaviors.
How this applies: Exact daridorexant RxCUI 2591497 IN, with stated salt/formulation/route bridge.
No exact botanical extract PK trial or supplement-combination incidence; distinguish modeled strong-modifier effects from measured clinical data.
Source 2: Federal medication information
medlineplus.gov · Source check Sep 10, 2026
Population: People prescribed daridorexant
Specifically names St John’s wort as an interacting herbal product and directs discussion before starting it.
How this applies: Exact daridorexant and named Hypericum precaution.
Patient guidance, not an original herb-daridorexant PK study or quantified interaction.
Source 3: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 24 male subjects in randomized open-label study.
Famotidine lowered peak39% without changing AUC. Efavirenz lowered AUC61%, peak35%, half-life35%. Treatments well tolerated.
How this applies: 24 healthy males; no botanical. Authors proposed allowing moderate inducers based on efficacy extrapolation, but current US labeling directs avoidance. No direct herb clinical benefit endpoint.
24 healthy males; no botanical. Authors proposed allowing moderate inducers based on efficacy extrapolation, but current US labeling directs avoidance. No direct herb clinical benefit endpoint.
Source 4: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 12 healthy adults.
Short-term dosing had no measured CYP effect; repeated use reduced oral midazolam AUC more than IV AUC.
How this applies: Original source interpreted for daridorexant only within the stated preparation and endpoint limits.
Not a direct daridorexant combination trial; original preparation, dose and endpoint limits apply. No exact-pair adverse-event rate or protective spacing established.
Source 5: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 20 healthy men.
Small AUC decrease considered not clinically relevant by authors; no significant Cmax or half-life change.
How this applies: Original source interpreted for daridorexant only within the stated preparation and endpoint limits.
Not a direct daridorexant combination trial; original preparation, dose and endpoint limits apply. No exact-pair adverse-event rate or protective spacing established.
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 | |
| Prepared exact daridorexant article with formulation-specific evidence and uncertainty. |
Article revision: 820da7b09d7c50ec
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.