Ritonavir and St. John's wort interaction

Ritonavir and St. John's wort: the Ritonavir prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Ritonavir (Norvir) label · effective 2026-07-23

Major

John's Wort (hypericum perforatum) NORVIR is contraindicated in patients with known hypersensitivity to ritonavir (e.g., toxic epidermal necrolysis, Stevens-Johnson syndrome) or any of its ingredients ( 4 )

Contraindicationsnames St. John's wortView label on DailyMed
Major

John's Wort (hypericum perforatum) ↓ ritonavir Contraindicated due to potential for loss of virologic response and possible resistance to NORVIR or to the class of protease inhibitors [see Contraindications ( 4 ) ] .

Drug interactionsnames St. John's wortView label on DailyMed

Curated guidance for St. John's wort

Major

St. John's wort can lower blood levels of some HIV medicines enough to cause treatment failure.

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Not 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.