HERBAL MEDICINES OR DIETARY SUPPLEMENTS AND NNRTIS

There is evidence to suggest that St John's wort (Hypericum perforatum) may decrease blood levels of nevirapine (clearance increased by 35%). Similar interactions are possible with delavirdine and efavirenz.
This supports the advice issued by the CSM in the UK, that St John's wort may decrease blood levels of the NNRTIs with possible loss of HIV suppression. Combined use should be avoided.
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