Supplement stacks / St Johns Wort + Tacrolimus
Can You Take St Johns Wort with Tacrolimus?
St. John's Wort is known to interact with tacrolimus, potentially reducing its effectiveness by inducing cytochrome P450 enzymes. This could lead to inadequate immunosuppression, increasing the risk of transplant rejection. Caution is advised, and consultation with a healthcare provider is essential before combining these substances.
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.
St. John's Wort may decrease the plasma concentration of tacrolimus, leading to reduced immunosuppressive effects.
Generally considered safe for mild depression but can interact with many medications.
Typical dosage: 300-900 mg daily, divided into doses.
- Gastrointestinal upset
- Fatigue
- Allergic skin reactions
- Consult healthcare provider before use, especially with tacrolimus.
- May cause photosensitivity.
Effective immunosuppressant but requires careful monitoring of blood levels.
Typical dosage: 0.1-0.2 mg/kg/day, adjusted based on blood levels.
- Kidney toxicity
- Hypertension
- Increased risk of infections
- Monitor kidney function and blood pressure regularly.
- Avoid grapefruit juice.
These come up in questions about this combination — they are not part of the pair above.
Omega-3 Fatty Acids
Generally safe; may support cardiovascular health and reduce inflammation.
Typical dosage: 1000-3000 mg daily.
- Fishy aftertaste
- Gastrointestinal discomfort
- Consult healthcare provider if on anticoagulants.
- Monitor for bleeding risk.
Vitamin D3
Essential for bone health; generally safe in recommended doses.
Typical dosage: 600-2000 IU daily, depending on blood levels.
- Nausea
- Constipation
- Fatigue
- Monitor blood levels to avoid toxicity.
- Consult healthcare provider for dosage adjustments.
Magnesium
Important for many bodily functions; generally safe but can cause diarrhea in high doses.
Typical dosage: 310-420 mg daily, depending on age and sex.
- Diarrhea
- Nausea
- Abdominal cramping
- Consult healthcare provider if on diuretics or heart medications.
- Monitor for interactions.
If St. John's Wort is deemed necessary, it should be taken at least 4 hours apart from tacrolimus to minimize interaction risks.
- Avoid taking St. John's Wort with tacrolimus; consult healthcare provider for alternatives.
Can you take St Johns Wort and Tacrolimus together?
St. John's Wort is known to interact with tacrolimus, potentially reducing its effectiveness by inducing cytochrome P450 enzymes. This could lead to inadequate immunosuppression, increasing the risk of transplant rejection. Caution is advised, and consultation with a healthcare provider is essential before combining these substances.
How safe is the St Johns Wort and Tacrolimus 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 St Johns Wort and Tacrolimus?
If St. John's Wort is deemed necessary, it should be taken at least 4 hours apart from tacrolimus to minimize interaction risks.
What should you watch out for when combining St Johns Wort and Tacrolimus?
Avoid taking St. John's Wort with tacrolimus; consult healthcare provider for alternatives.
Taking more than these two? Run your complete supplement list — plus any medications — through the live checker for a combined analysis.
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Analysis generated August 11, 2026 · Sources include NIH, Mayo Clinic, WebMD, and Examine.com · How our analysis works