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Dietary supplement

Hypericum Perforatum II St. John's Wort Extract Ingredients & Drug Interactions

by HBC Protocols

Hypericum Perforatum II St. John's Wort Extract label
See full label image
Tablet Or Pill Category: Botanical
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Hypericum Perforatum II St. John's Wort Extract against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Hypericum Perforatum II St. John's Wort Extract is a dietary supplement by HBC Protocols with 2 active ingredients. Its ingredients are commonly taken for mild to moderate depression, anxiety and stress, sleep problems.Based on those ingredients, 1,225 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are ST. JOHN'S WORT, LucoSelect. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Hypericum Perforatum II St. John's Wort Extract by HBC Protocols

Ask about any prescription or over-the-counter medication and we check it for interactions with Hypericum Perforatum II St. John's Wort Extract by HBC Protocols — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Hypericum Perforatum II St. John's Wort Extract by HBC Protocols

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Aug 6, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 2 of its 2 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains 2 active ingredients. St.

John's wort is an herbal extract used for mood support, and LucoSelect is a grape seed extract. The tablet also includes inactive ingredients—dibasic calcium phosphate, microcrystalline cellulose, vegetable oil, croscarmelose sodium, magnesium stearate, and silicon dioxide—which are fillers and binders that help hold the pill together.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: promotes balanced emotional outlook.
  • We looked for evidence on: Anxiety, Depression, Seasonal affective disorder (SAD), Social anxiety disorder, mood regulation, emotional wellness.
  • The strongest evidence on file: St. John's Wort is rated "Likely Effective" for Depression (Natural Medicines).
  • Also on file: St. John's Wort is rated "Possibly Ineffective" for Social anxiety disorder.
  • Also on file: St. John's Wort is rated "Insufficient Reliable Evidence To Rate" for Anxiety, Seasonal affective disorder (SAD).

St. John's wort is likely effective for depression based on clinical evidence.

It's also possibly effective for somatic symptom disorder and menopausal symptoms, though the evidence is weaker. For HIV/AIDS and irritable bowel syndrome, the evidence suggests it's likely ineffective.

The grape extract (LucoSelect) is possibly effective for chronic venous insufficiency (heaviness or swelling in the legs from poor circulation) but possibly ineffective for chemotherapy nausea, hay fever, and weight management. The strength of evidence varies across these uses.

The evidence, ingredient by ingredient St. John's Wort Grape

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

St. John's wort is generally well tolerated for short-term use but comes with real caution flags.

The most common side effects are diarrhea, dizziness, dry mouth, mild stomach upset, fatigue, headache, insomnia, and restlessness. It can cause sun sensitivity—both with topical use and when taken by mouth at higher doses—so sun protection matters if you're on this.

Rare but serious effects include suicidal thoughts and psychosis; it can also trigger mood episodes (hypomania or mania) in people with depression, especially those with undiagnosed bipolar disorder. Safety data advises against St.

John's wort during pregnancy and while breastfeeding because there isn't enough reliable information and it may pass into breast milk and harm infants. The grape extract is generally well tolerated, though it can cause stomach pain, diarrhea, dry mouth, indigestion, headache, joint pain, and nausea.

Anaphylaxis to grape skin is rare. Grape as whole food is safe in pregnancy and breastfeeding, but concentrated grape supplements are best avoided in pregnancy due to limited data.

Side effects, ingredient by ingredient St. John's Wort Grape

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 2 of the 2 matched ingredients can interact with medications — St. John's Wort, Grape.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; heart-rhythm medications.
  • For scale: 1,226 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check with your doctor or pharmacist before taking this if you're on digoxin (a heart drug), phenobarbital or phenytoin (seizure drugs), irinotecan or docetaxel (cancer drugs), protease inhibitors for HIV, tacrolimus (for transplant rejection), blood thinners or antiplatelet drugs, cyclosporine (immunosuppressant), midazolam (a sedative), or any drugs metabolized by the liver enzymes CYP1A2, CYP2D6, CYP3A4, or CYP2E1. St.

John's wort is a potent inducer that speeds up how your liver clears many medications, which can make them less effective.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

This product is mainly for people exploring St. John's wort for depression or mood support, or grape extract for circulation issues—but only if you're not taking medications that interact with it, which is a long list.

Anyone on heart, seizure, cancer, HIV, transplant, or blood-thinning drugs absolutely needs to discuss this with their doctor or pharmacist before starting. The same goes if you're pregnant, breastfeeding, or have a history of mood disorders or psychosis.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jul 25, 2012.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Hypericum Perforatum II St. John's Wort Extract, straight from the product label.

Brand HBC Protocols
Net contents 280 Tablet(s); 300 mg
Market status On market
Date entered into DSLD Jul 25, 2012
DSLD ID 11365
Product type Botanical
Supplement form Tablet Or Pill
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Dairy Free, Sugar Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Hypericum Perforatum II St. John's Wort Extract by HBC Protocols, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Tablet(s)
Maximum serving Sizes:
1 Tablet(s)
IngredientAmount% DV
ST. JOHN'S WORT300 mg--
LucoSelect1 mg--

Other ingredients: Dibasic Calcium Phosphate, Microcrystalline Cellulose, Vegetable oil, Croscarmelose Sodium, Magnesium Stearate, Silicon Dioxide

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Brand IP Statement(s)

LeucoSelect(R), St. JohnSelect(TM) and indena(TM) are trademarks of Indena S.p.A.

General Statements

Promotes a Balanced Emotional Outlook

Research grade

National Institutes of Health tested and approved.

Formula

Standardized to contain 0.3% hypericin, minimum 4% hyperforin

Formulated with super-antioxidant LeucoSelect to protect and ensure Hyperforin stability.

Formulation

No animal products are used in this product. Contains no sugar, starch, yeast, artificial colors, preservatives or dairy products.

Precautions

Keep out of the reach of children.

Not to be used by people taking MAO inhibitors.

May cause hypersensitivity to sunlight.

Not to be taken by pregnant women. Talk to your doctor if you are on prescription medication.

Suggested/Recommended/Usage/Directions

Directions for Use: Adults: as a dietary supplement, take one tablet three times daily.

FDA Disclaimer Statement

This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diag-

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Hypericum Perforatum II St. John's Wort Extract by HBC Protocols label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Hypericum Perforatum II St. John's Wort Extract label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Hypericum Perforatum II St. John's Wort Extract by HBC Protocols

These are the 2 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Tablet(s) Dosage formTablet Or Pill Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

ST. JOHN'S WORT

Interacts with
1,143 drugs
300 mg per serving Form: Hyperforin

St. John's wort is a well-studied herb most often used for mild to moderate depression, and some research suggests it may help with this. However, it...

ST. JOHN'S WORT monograph & interactions

LucoSelect

Interacts with
910 drugs
1 mg per serving

Grapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and b...

LucoSelect monograph & interactions

Other (inactive) ingredients: Dibasic Calcium Phosphate, Microcrystalline Cellulose, Vegetable oil, Croscarmelose Sodium, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

Hypericum Perforatum II St. John's Wort Extract by HBC Protocols Drug Interactions

Want to check YOUR meds against Hypericum Perforatum II St. John's Wort Extract?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,225Drugs
755 Major 470 Moderate

Ingredients driving the most interactions

ST. JOHN'S WORT 1,143
LucoSelect 910

Individual Drug Interactions

The ingredients in Hypericum Perforatum II St. John's Wort Extract interact with 1,225 drugs. Click any drug to see the details.

2 of the 2 ingredients in Hypericum Perforatum II St. John's Wort Extract interact with drugs. Each result below shows which ingredient is responsible. ST. JOHN'S WORT LucoSelect

Each ingredient & the kinds of drugs it affects

For each ingredient in Hypericum Perforatum II St. John's Wort Extract with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

ST. JOHN'S WORT47 drug types · 1,143 drugs

Alprazolam (Xanax)

St. John's wort increases the clearance of alprazolam and decreases its effects.
Alprazolam, which is used as a probe for cytochrome P450 3A4 (CYP3A4) activity, has a two-fold increase in clearance when given with St. John's wort. St. John's wort reduces the half-life of alprazolam from 12.4 hours to 6 hours.

Likelihood Likely Evidence B
Contraceptive Drugs

St. John's wort increases the clearance of contraceptive drugs and reduces their clinical effects.
Females taking St. John's wort and oral contraceptives concurrently should use an additional or alternative form of birth control. St. John's wort can decrease norethindrone and ethinyl estradiol levels by 13% to 15%, resulting in breakthrough bleeding, irregular menstrual bleeding, or unplanned pregnancy. Bleeding irregularities usually occur within a week of starting St. John's wort and regular cycles usually return when St. John's wort is discontinued. Unplanned pregnancy has occurred with concurrent use of oral contraceptives and St. John's wort extract. St. John's wort is thought to induce the cytochrome P450 1A2 (CYP1A2), 2C9 (CYP2C9), and 3A4 (CYP3A4) enzymes, which are responsible for metabolism of progestins and estrogens in contraceptives.

Likelihood Probable Evidence B
Cyclosporine (Neoral, Sandimmune)

St. John's wort reduces the levels and clinical effects of cyclosporine.
Concomitant use can decrease plasma cyclosporine levels by 30% to 70%. Using St. John's wort with cyclosporine in patients with heart, kidney, or liver transplants can cause subtherapeutic cyclosporine levels and acute transplant rejection. This interaction has occurred with a St. John's wort extract standardized to 0.3% hypericin and dosed at 300-600 mg per day. Withdrawal of St. John's wort can result in a 64% increase in cyclosporine levels. St. John's wort induces cytochrome P450 3A4 (CYP3A4) and the multi-drug transporter, P-glycoprotein/MDR-1, which increases cyclosporine clearance.

Likelihood Probable Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

St. John's wort increases the metabolism and reduces the levels of CYP3A4 substrates.
St. John's wort induces CYP3A4 enzymes and increases metabolism of CYP3A4 substrates. Clinically significant interactions have been reported with St. John's wort products containing hyperforin 1 mg or more.

Likelihood Probable Evidence B
Digoxin (Lanoxin)

St. John's wort reduces the levels and clinical effects of digoxin.
St. John's wort can reduce the bioavailability, serum levels, and therapeutic effects of digoxin. Taking an extract of St. John's wort 900 mg, containing hyperforin 7.5 mg or more, daily for 10-14 days, can reduce serum digoxin levels by 25% in healthy people. St. John's wort is thought to affect the multidrug transporter, P-glycoprotein, which mediates the absorption and elimination of digoxin and other drugs. St. John's wort products providing less than 7.5 mg of hyperforin daily do not appear to affect digoxin levels.

Likelihood Likely Evidence B
Docetaxel (Taxotere)

St. John's wort reduces the levels and clinical effects of docetaxel.
Clinical research shows that taking a specific St. John's wort product (Hyperiplant, VSM) 300 mg three times daily for 14 days increases docetaxel clearance by about 14%, resulting in decreased plasma concentrations of docetaxel in cancer patients. This is most likely due to induction of cytochrome P450 3A4 (CYP3A4) by St. John's wort.

Likelihood Probable Evidence B
Imatinib (Gleevec)

St. John's wort reduces the levels and clinical effects of imatinib.
Taking St. John's wort 900 mg daily for 2 weeks reduces the bioavailability and half-life of a single dose of imatinib and decreases its serum levels by 30% in healthy volunteers. This is most likely due to induction of cytochrome P450 3A4 (CYP3A4) by St. John's wort, which increases clearance of imatinib.

Likelihood Likely Evidence A
Irinotecan (Camptosar)

St. John's wort reduces the levels and clinical effects of irinotecan.
St. John's wort 900 mg daily for 18 days decreases serum levels of irinotecan by at least 50%. Clearance of the active metabolite of irinotecan, SN-38, is also increased, resulting in a 42% decrease in the area under the concentration-time curve. This is thought to be due to induction of cytochrome P450 3A4 (CYP3A4) by St. John's wort.

Likelihood Likely Evidence A
Mephenytoin (Mesantoin)

St. John's wort reduces the levels and clinical effects of mephenytoin.
Preliminary clinical research in healthy males shows that taking St. John's wort for 14 days induces cytochrome P450 2C19 (CYP2C19) and significantly increases metabolism of mephenytoin (Mesantoin). In people with wild-type 2C19, metabolism was almost 4-fold greater in subjects who received St. John's wort compared to placebo. In contrast, patients with 2C19*2/*2 and *2/*3 genotypes did not demonstrate a similar increase in metabolism.

Likelihood Likely Evidence B
Non-Nucleoside Reverse Transcriptase Inhibitors (Nnrtis)

St. John's wort decreases the levels and clinical effects of NNRTIs.
St. John's wort increases the oral clearance of nevirapine (Viramune) by 35%. Subtherapeutic concentrations are associated with therapeutic failure, development of viral resistance, and development of drug class resistance. St. John's wort induces intestinal and hepatic cytochrome P450 3A4 (CYP3A4) and intestinal P-glycoprotein/MDR-1, a drug transporter.

Likelihood Likely Evidence B
Omeprazole (Prilosec)

St. John's wort decreases the levels and clinical effects of omeprazole.
Taking St. John's wort, 300 mg orally three times daily for 14 days, reduces serum concentrations of omeprazole by inducing its metabolism via cytochrome P450 (CYP) 2C19 and 3A4. The reduction of omeprazole serum levels is dependent on CYP2C19 genotype, with reductions up to 50% in extensive metabolizers and 38% in poor metabolizers.

Likelihood Likely Evidence B
Oxycodone (Oxycontin)

St. John's wort decreases the levels and clinical effects of oxycodone.
St. John's wort can increase oxycodone metabolism by inducing cytochrome P450 3A4 (CYP3A4), reducing plasma levels and analgesic activity.

Likelihood Probable Evidence B
P-Glycoprotein Substrates

St. John's wort decreases the levels and clinical effects of P-glycoprotein substrates.
St. John's wort induces P-glycoprotein. P-glycoprotein is a carrier mechanism responsible for transporting drugs and other substances across cell membranes. When P-glycoprotein is induced in the gastrointestinal (GI) tract, it can prevent the absorption of some medications. In addition, induction of p-glycoprotein can decrease entry of drugs into the central nervous system (CNS) and decrease access to other sites of action.

Likelihood Probable Evidence B
Phenobarbital (Luminal)

St. John's wort decreases the levels and clinical effects of phenobarbital.
St. John's wort may increase the metabolism of phenobarbital. Plasma concentrations of phenobarbital should be monitored carefully. The dose of phenobarbital may need to be increased when St. John's wort is started and decreased when it is stopped.

Likelihood Likely Evidence B
Phenprocoumon (Marcoumar, Others)

St. John's wort decreases the levels and clinical effects of phenprocoumon.
St. John's wort appears to increase the metabolism of phenprocoumon (an anticoagulant that is not available in the US) by increasing the activity of the cytochrome P450 2C9 (CYP2C9) enzyme. This may result in decreases in the anticoagulant effect and international normalized ratio (INR).

Likelihood Likely Evidence B
Phenytoin (Dilantin)

St. John's wort decreases the levels and clinical effects of phenytoin.
St. John's wort may increase the metabolism of phenytoin. Plasma concentrations of phenytoin should be monitored closely. The dose of phenytoin may need to be increased when St. John's wort is started and decreased when it is stopped.

Likelihood Likely Evidence B
Protease Inhibitors (Pis)

St. John's wort reduces the levels and clinical effects of PIs.
In healthy volunteers, St. John's wort can reduce the plasma concentrations of indinavir (Crixivan) by inducing cytochrome P450 3A4 (CYP3A4). This might result in treatment failure and viral resistance. St. John's wort also induces P-glycoprotein, which can result in decreased intracellular protease inhibitor concentrations and increased elimination.

Likelihood Likely Evidence B
Rivaroxaban (Xarelto)

St. John's wort decreases the levels and clinical effects of rivaroxaban.
A small pharmacokinetic study in healthy volunteers shows that taking a single dose of rivaroxaban 20 mg after using a specific St. John's wort extract (Jarsin, Vifor SA) 450 mg orally twice daily for 14 days reduces the bioavailability of rivaroxaban by 24% and reduces rivaroxaban's therapeutic inhibition of factor Xa by 20%.

Likelihood Probable Evidence B
Tacrolimus (Prograf)

St. John's wort decreases the levels and clinical effects of tacrolimus.
Taking a St. John's wort extract (Jarsin) 600 mg daily significantly decreases tacrolimus serum levels. Dose increases of 60% may be required to maintain therapeutic tacrolimus levels in patients taking St. John's wort. St. John's wort is thought to lower tacrolimus levels by inducing cytochrome P450 3A4 (CYP3A4) enzymes. A small clinical study in healthy adults also shows that taking St. John's wort 300 mg three times daily for 10 days decreases the total systemic exposure to tacrolimus by 27% and 33% after taking a single 5 mg dose of immediate-release or prolonged-release tacrolimus, respectively.

Likelihood Likely Evidence B
Warfarin (Coumadin)

St. John's wort decreases the levels and clinical effects of warfarin.
Taking St. John's wort significantly increases clearance of warfarin, including both its R- and S-isomers. This is likely due to induction of cytochrome P450 (CYP) 1A2 and CYP3A4. St. John's wort can also significantly decrease International Normalized Ratio (INR) in people taking warfarin. In addition, taking warfarin at the same time as St. John's wort might reduce warfarin bioavailability. When a dried extract is mixed with warfarin in an aqueous medium, up to 30% of warfarin is bound to particles, reducing its absorption.

Likelihood Likely Evidence B
Aminolevulinic Acid

St. John's wort might have additive phototoxic effects with aminolevulinic acid.
Concomitant use with St. John's wort extract may cause synergistic phototoxicity. Delta-aminolevulinic acid can cause a burning erythematous rash and severe swelling of the face, neck, and hands when taken with St. John's wort.

Likelihood Possible Evidence D
Bupropion (Wellbutrin)

St. John's wort might reduce the levels and effects of bupropion.
Clinical research shows that taking St. John's wort 325 mg three times daily for 14 days along with bupropion reduces the area under the concentration-time curve by approximately 14% and increases the clearance of bupropion by approximately 20%. This effect is attributed to the induction of cytochrome P450 2B6 (CYP2B6) by St. John's wort.

Likelihood Probable Evidence B
Clopidogrel (Plavix)

St. John's wort might increase the levels and effects of clopidogrel.
Taking St. John's wort with clopidogrel seems to increase the activity of clopidogrel. In clopidogrel non-responders, taking St. John's wort seems to induce metabolism of clopidogrel to its active metabolite by cytochrome P450 enzymes 3A4 and 2C19. This leads to increased antiplatelet activity. Theoretically, this might lead to an increased risk of bleeding in clopidogrel responders.

Likelihood Possible Evidence B
Clozapine (Clozaril)

St. John's wort might decrease the levels and clinical effects of clozapine.
A case report describes a female with schizophrenia controlled on clozapine who had a return of symptoms when she started taking St. John's wort. The plasma concentration of clozapine was reduced, likely because its clearance was increased due to induction of the cytochrome P450 enzymes 3A4, 1A2, 2C9, and 2C19 by St. John's wort.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

St. John's wort may increase the metabolism and reduce the levels of CYP1A2 substrates.
Clinical and in vitro research shows that St. John's wort induces CYP1A2, but to a lesser extent than CYP3A4.

Likelihood Possible Evidence B
ST. JOHN'S WORT full monograph & all 47 interactions

LucoSelect9 drug types · 910 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, grape extracts may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In vitro evidence suggests that grape extracts might decrease platelet aggregation.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

Ingesting grape juice with cyclosporine can reduce cyclosporine absorption.
A small pharmacokinetic study in healthy young adults shows that intake of purple grape juice 200 mL along with cyclosporine can decrease the absorption of cyclosporine by up to 30% when compared with water. Separate doses of grape juice and cyclosporine by at least 2 hours to avoid this interaction.

Likelihood Possible Evidence B
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, grape juice might reduce the levels of CYP1A2 substrates.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of CYP1A2.

Likelihood Possible Evidence B
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, grape seed extract may increase the levels of CYP2D6 substrates.
In vitro evidence suggests that grape seed extract might inhibit CYP2D6 enzymes. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2E1 (Cyp2E1) Substrates

Theoretically, grape seed extract might increase the levels of CYP2E1 substrates.
In vitro and animal research suggests that grape seed proanthocyanidin extract inhibits CYP2E1 enzymes. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

It is unclear if grape seed extract inhibits or induces CYP3A4; research is conflicting.
In vitro evidence suggests that grape seed extract might inhibit CYP3A4 enzymes. However, evidence from animal research shows that grape seed extract may induce CYP3A4 in the liver. So far, these interactions have not been reported in humans.

Likelihood Possible Evidence D
Midazolam (Versed)

Theoretically, long-term intake of grape seed extract might decrease the effects of midazolam.
Animal research shows that subchronic ingestions of grape seed extract can increase the elimination of intravenous midazolam by increasing hepatic CYP3A4 activity. Single doses of grape seed extract do not appear to affect midazolam elimination.

Likelihood Possible Evidence D
Phenacetin

Grape juice might decrease phenacetin absorption.
A small pharmacokinetic study in healthy adults shows that ingestion of 200 mL of grape juice decreases phenacetin plasma levels. This is thought to be due to induction of cytochrome P450 1A2 (CYP1A2).

Likelihood Possible Evidence B
Cytochrome P450 2C9 (Cyp2C9) Substrates

It is unclear if grape juice or grape seed extract inhibits CYP2C9; research is conflicting.
In vitro evidence shows that grape seed extract or grape juice might inhibit CYP2C9 enzymes. However, a small pharmacokinetic study in healthy adults shows that drinking 8 ounces of grape juice once does not affect the clearance of flurbiprofen, a probe-drug for CYP2C9 metabolism. The effects of continued grape juice consumption are unclear.

Likelihood Unlikely Evidence D
LucoSelect full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Hypericum Perforatum II St. John's Wort Extract, from the product label.

HBC Protocols

See all HBC Protocols products
Name
hbc Protocols
Street Address
8205 Santa Monica Blvd. Suite 472
City
Los Angeles
State
CA
ZipCode
90046
Phone Number
888.497.3742
Web Address
www.hbcstore.com
Pharmacist Counseling Corner

Hypericum Perforatum II St. John's Wort Extract by HBC Protocols: Common Questions

Does Hypericum Perforatum II St. John's Wort Extract by HBC Protocols interact with any medications?
Yes. Based on its ingredients, Hypericum Perforatum II St. John's Wort Extract has a known interaction with 1,225 medications, including 755 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Hypericum Perforatum II St. John's Wort Extract contains 2 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm pregnant or breastfeeding?
No, the safety data advises against both. There isn't enough reliable information about St. John's wort in pregnancy, and it may pass into breast milk and cause side effects in infants. Talk with your doctor or pharmacist about safer options for your situation.
What's the difference between the two ingredients—St. John's wort and LucoSelect?
St. John's wort is an herbal extract traditionally used for mood and depression support. LucoSelect is a grape seed extract, used for circulation and vein health. The product combines both in one tablet.
Will this help my depression?
St. John's wort is likely effective for depression based on clinical evidence. But because of its serious interactions with many medications, you'll want to clear it with your doctor or pharmacist first, especially if you're on any prescription drugs.
What are the most common side effects?
For St. John's wort: diarrhea, dizziness, dry mouth, fatigue, headache, insomnia, and restlessness. For the grape extract: stomach pain, diarrhea, dry mouth, indigestion, headache, joint pain, and nausea. St. John's wort can also make your skin more sensitive to the sun.
Can St. John's wort trigger mood problems?
Yes—it can bring on hypomania (elevated mood) or mania in people with depression, especially those with undiagnosed bipolar disorder. Cases of first-episode psychosis have also been reported. If you have a history of mood disorders or psychosis, talk with your doctor before starting.
Why is there such a long list of drug interactions?
St. John's wort speeds up how your liver breaks down many medications by inducing key enzymes. This can make those drugs less effective—sometimes dangerously so, as with heart and cancer medications. That's why the interaction count is so high.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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The Full Monographs Behind Hypericum Perforatum II St. John's Wort Extract’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

St. John's Wort

Interacts with 1,143 drugs

St. John's wort is a well-studied herb most often used for mild to moderate depression, and some research suggests it may help with this. However, it has many serious interactions with presc...

Read the full St. John's Wort monograph → Herb & supplement monograph

Grape

Interacts with 910 drugs

Grapes and grape products like grape seed extract contain antioxidant compounds such as resveratrol and proanthocyanidins that may support heart and blood vessel health. While the food is he...

Read the full Grape monograph →
Sources

Sources & How We Checked

Hypericum Perforatum II St. John's Wort Extract's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 186 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

St. John's Wort 152 references
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See these in context on the St. John's Wort monograph →

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See these in context on the Grape monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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