The short answer
An exact St John’s wort-oxazepam interaction has not been established. Results showing altered alprazolam metabolism should not automatically be applied to oxazepam.
What this answer covers
Oral Hypericum perforatum extracts with oxazepam; CYP3A probe findings and glucuronide metabolism are distinct.
- Supplement or preparation
- Hypericum perforatum
- Medication ingredient
- oxazepam
The metabolism differs between medicines
Oxazepam has a major inactive glucuronide metabolite. A St John’s wort study measured faster clearance of alprazolam through CYP3A-related effects, not oxazepam handling.
The preparation also matters
A low-hyperforin St John’s wort product had little effect on alprazolam exposure in another study. That finding does not prove safety with oxazepam, but it shows why all herbal products cannot be treated identically.
Ask for review rather than assuming a rule
Tell the pharmacist the exact extract and daily dose. No demonstrated oxazepam interaction magnitude or protective spacing interval was identified.
Keep treatment changes supervised
Follow the prescribed oxazepam plan. Do not take extra doses to counter a supplement, and do not stop regular treatment abruptly. Ask the prescriber to plan any medication or supplement changes.
Evidence and practical considerations
Absorption & effectiveness
No exact oxazepam effect is established by alprazolam CYP3A induction or a generic herbal interaction rule.
- Exact scope
- Oral Hypericum perforatum extracts with oxazepam; CYP3A probe findings and glucuronide metabolism are distinct. with Exact oral oxazepam; no blanket benzodiazepine metabolic or route transfer.
- Medication form and route
- oral; other cannabis routes only if explicitly discussed
- Timing or duration
- Exact duration and dose depend on source; single-dose and chronic use are distinguished.
What remains uncertain
- No exact human co-use study identified; extract composition varies and oxazepam has a different metabolic profile.
Factors that may matter: preparation and plant part; dose; other medicines; baseline alertness; clinical indication.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Patients prescribed oral oxazepam.
CNS depression, impaired coordination and alertness can occur; concomitant CNS depressants require caution. Dependence and withdrawal risks require individualized tapering rather than abrupt cessation. A single major inactive glucuronide metabolite is excreted in urine. CYP3A interactions measured with alprazolam cannot simply be assigned to oxazepam.
How this applies: Exact RxNorm ingredient and oral formulation confirmed in original label; use exact indication and metabolic boundaries.
Does not quantify the requested botanical interaction risks, prove every herb is sedating, or establish a protective supplement interval.
Source 2: 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: Apply only to exact medication, preparation and study exposure; comparator treatment is not co-use.
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 3: 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: Apply only to exact medication, preparation and study exposure; comparator treatment is not co-use.
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 |
|---|---|
| Article prepared | |
| Current exact claims adjudicated against captured originals and explicit comparator/co-use boundaries. | |
| Research summary published |
Article revision: 95e3464b75bb64d4
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.