Lopinavir and ritonavir and St. John's wort interaction
Lopinavir and ritonavir and St. John's wort: the Lopinavir and ritonavir prescribing label flags this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Lopinavir and ritonavir (Kaletra) label · effective 2026-07-23
John's Wort (hypericum perforatum) Hypersensitivity to KALETRA (e.g., toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, urticaria, angioedema) or any of its ingredients, including ritonavir.
John's Wort (hypericum perforatum) ↓ lopinavir Contraindicated due to potential for loss of virologic response and possible resistance to KALETRA or to the class of protease inhibitors [see Contraindications ( 4 )] .
Curated guidance for St. John's wort
St. John's wort can lower blood levels of some HIV medicines enough to cause treatment failure.
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.