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St John's wort and antiretrovirals — GPhC CRA MCQ

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HardDrug InteractionsSt John's wort and antiretroviralsGPhC CRA

A 44-year-old man with HIV takes antiretroviral therapy supplied by a specialist clinic. He asks to buy St John's wort for low mood. He does not know the names of his HIV medicines. What is the most important interaction to flag?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Do not supply and advise specialist or prescriber review because St John's wort can reduce antiretroviral levels.

St John's wort induces metabolic pathways and can substantially reduce concentrations of several antiretroviral medicines, risking virological failure and resistance. Without knowing the regimen, supply is unsafe. The patient should be directed to the HIV clinic or prescriber for advice.

Reference: BNF