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Severe· well-documented
Avoid this combination unless your prescriber explicitly approves it with appropriate monitoring.
St. John's Wort reduces digoxin levels by approximately 25%, potentially reducing its cardiac effects.
Induction of P-glycoprotein in the intestine reduces digoxin absorption and increases renal excretion.
Source: Natural Medicines Database · Reviewed April 2026
St. John's Wort + Digoxin: high risk. Avoid this combination unless your prescriber explicitly approves it with appropriate monitoring. St. John's Wort reduces digoxin levels by approximately 25%, potentially reducing its cardiac effects.
Induction of P-glycoprotein in the intestine reduces digoxin absorption and increases renal excretion.
Do not stop either abruptly on your own. Talk to your prescriber or pharmacist promptly — bring this page to your appointment.
Educational information only — not medical advice. Always verify with a healthcare professional.