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St. john’s wort + oral contraceptives, warfarin, ssris, hiv meds…
strong cyp3a4 inducer. decreases drug levels or triggers serotonin syndrome
ginkgo biloba/garlic/vitamin e + anticoagulants
increases risk of bleeding
calcium/iron suupplements + levothyroxine, tetracyclines
chelates the medication, blocking oral absorption
kava/valerian root + CNS depressants (alcohol, benzodiazepines…)
severe sedation, motor impairment, and potential hepatotoxicity