Decreases serum levels of verapamil via CYP induction — monitor for signs of reduced drug effectiveness and adjust the dose if necessary.


Vi/ Metabolism of warfarin is chiefly by CYP2C9, and a minor metabolic pathway is

CYP3A4, so theoretically it may interact with SJW. A clinical study found no change to INR or platelet aggregation (Jiang et al 2004), but there are case reports suggesting SJW may lower the INR — caution is advised.

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