Supplement stacks / Rivaroxaban + St Johns Wort

Can You Take Rivaroxaban with St Johns Wort?

St. John's Wort is known to induce cytochrome P450 enzymes, which can significantly reduce the effectiveness of rivaroxaban, an anticoagulant. This interaction poses a risk of increased thromboembolic events due to subtherapeutic levels of rivaroxaban. Therefore, combining these two substances is not recommended without medical supervision.

Safety at a glance
High risk
Safety score3/10

Conservative, AI-assisted reading of publicly available medical sources (NIH, Mayo Clinic, WebMD, Examine.com). Informational only — it can't account for your medications, conditions, or genetics.

Known interactions

St. John's Wort may decrease the plasma concentration of rivaroxaban, leading to reduced anticoagulant effect.

Rivaroxaban

Effective anticoagulant; monitor for bleeding risks.

Typical dosage: 10-20 mg daily, depending on indication

Common side effects:
  • Bleeding
  • Anemia
  • Nausea
Warnings:
  • Monitor INR more frequently if taking with potential interacting substances.
St. John's Wort

Generally considered safe for short-term use; however, it can interact with many medications.

Typical dosage: 300-900 mg daily, divided into doses

Common side effects:
  • Gastrointestinal upset
  • Fatigue
  • Allergic skin reactions
Warnings:
  • May cause photosensitivity; consult healthcare provider if taking other medications, especially anticoagulants.
Timing

If St. John's Wort is deemed necessary, it should be taken at least 4 hours apart from rivaroxaban to minimize interaction risk, but ideally, it should be avoided altogether.

Recommendations
  • Avoid taking St. John's Wort while on rivaroxaban. Consult with a healthcare provider for alternative treatments for mood support.
Watch out for
  • Do not combine St. John's Wort with rivaroxaban without consulting a healthcare provider. Monitor for signs of reduced anticoagulation.
Frequently asked questions

Can you take Rivaroxaban and St Johns Wort together?

St. John's Wort is known to induce cytochrome P450 enzymes, which can significantly reduce the effectiveness of rivaroxaban, an anticoagulant. This interaction poses a risk of increased thromboembolic events due to subtherapeutic levels of rivaroxaban. Therefore, combining these two substances is not recommended without medical supervision.

How safe is the Rivaroxaban and St Johns Wort combination?

Our analysis of publicly available medical sources scores this combination 3/10 (high risk). This is an informational estimate, not medical advice — always confirm with a healthcare professional.

When should you take Rivaroxaban and St Johns Wort?

If St. John's Wort is deemed necessary, it should be taken at least 4 hours apart from rivaroxaban to minimize interaction risk, but ideally, it should be avoided altogether.

What should you watch out for when combining Rivaroxaban and St Johns Wort?

Do not combine St. John's Wort with rivaroxaban without consulting a healthcare provider. Monitor for signs of reduced anticoagulation.

Check your full stack

Taking more than these two? Run your complete supplement list — plus any medications — through the live checker for a combined analysis.

Analyze my stack
Personalize it with your DNA

Genetics change how you process supplements like these. Upload raw 23andMe or Ancestry data for a personalized supplement report.

See the DNA report

Analysis generated August 11, 2026 · Sources include NIH, Mayo Clinic, WebMD, and Examine.com · How our analysis works