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“As CYP3A4 is an important metabolic pathway for all DOACs except dabigatran, it appears reasonable to recommend avoiding the co-prescription of fluoxetine and fluvoxamine (weak to moderate CYP3A4 inhibitors) and St John’s wort (CYP3A4 inducer).”
Expert opinion on drug metabolism & toxicology • 2019 | View Paper
“Thus, the potency of various St. John's wort extracts for inhibiting the neuronal uptake of serotonin, a characteristic of conventional antidepressants such as fluoxetine , increases with increasing hyperforin content.”