VCVITAMINS/CHART

The Bottom Line

Yes, you can take St. John's Wort and Ginkgo Biloba together; they are considered safe to combine with no significant interaction reported.

VERDICT

St. John's Wort and Ginkgo Biloba together are generally safe for healthy adults, with no significant interaction between the two. The liver-enzyme effects of St. John's Wort do not alter how ginkgo's active compounds are handled. Still, both herbs influence clotting and mood pathways, so monitoring is wise if you take medications.

Safe to combine Limited evidence
01 / MECHANISM

How They Interact

St. John's Wort strongly induces cytochrome P450 enzymes, particularly CYP3A4 and CYP2C19, as well as the drug transporter P-glycoprotein, which speeds up the breakdown of many prescription drugs. Ginkgo biloba's active constituents (flavonoids and terpene lactones) are not primarily metabolized by these same CYP3A4 pathways in clinically significant amounts, so their blood levels are not meaningfully reduced by St. John's Wort. The two herbs also act on separate physiological targets: ginkgo inhibits platelet-activating factor and has mild antioxidant properties, while St. John's Wort inhibits serotonin reuptake and mildly modulates dopamine and norepinephrine. Because these mechanisms are distinct and do not compete for receptor binding or absorption, no inherent interaction occurs. The only shared area of concern is a theoretical additive effect on bleeding and serotonin levels, but typical doses do not push most people into a danger zone.

02 / BEST PRACTICES

How To Take Them

Take both supplements with breakfast to build a simple daily habit and place the enzyme-inducing effect of St. John's Wort early in the day. For most adults, splitting St. John's Wort into two smaller doses (morning and afternoon) and taking ginkgo in the morning is sensible, but a single combined dose works too. Always use standardized extracts and avoid taking them with grapefruit juice, which may interfere with enzyme activity. If you miss a dose, resume with the next scheduled dose and do not compensate for the missed one. When possible, have your doctor review your complete supplement list to ensure the herbal combination does not interact with other medicines you take.

03 / FORM MATTERS

Form & Quality Differences

Standardized extracts matter for predictable dosing. For St. John's Wort, look for products standardized to 0.3% hypericin or 3–5% hyperforin, as hyperforin is the main enzyme inducer. For Ginkgo biloba, the standardized extract EGb 761 (containing 24% flavone glycosides and 6% terpene lactones) is the most widely studied form. No form-specific difference in the way these two interact has been identified, so choose high-quality extracts from reputable manufacturers.

04 / COMMON STACKS

Where This Pair Shows Up

This pair occasionally appears in herbal blends marketed for memory and mood support, sometimes alongside Bacopa monnieri, lion's mane mushroom, or Panax ginseng. They are not a standard industrial stack, so always read the label of any 'cognitive vitality' formula you consider.

Multivitamins Prenatals Performance Longevity
05

Practical Tips

06

Frequently Asked Questions

Who Should Be Careful Avoid this combination during pregnancy and breastfeeding unless your healthcare provider explicitly approves it. If you take an SSRI, SNRI, MAOI, or triptan for migraines, adding both herbs could theoretically lead to serotonin syndrome, so professional oversight is essential. Ginkgo alone increases bleeding risk, so people using anticoagulants (warfarin, apixaban, rivaroxaban) or antiplatelet drugs should consult their doctor before combining it with St. John's Wort. Because St. John's Wort induces liver enzymes, it can reduce the effectiveness of birth control pills, certain heart medications, and immunosuppressants, so a medication review is key.
08

Sources & Further Reading

  1. NIH ODS NIH Office of Dietary Supplements — St. John's Wort Fact Sheet
  2. NIH ODS NIH Office of Dietary Supplements — Ginkgo Biloba Fact Sheet
  3. Examine.com Examine.com — St. John's Wort interaction page
  4. Examine.com Examine.com — Ginkgo Biloba interaction page

Reviewed by Caroline M. on April 8, 2025 for accuracy against the sources listed above. This page is educational and is not a substitute for professional medical advice.

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