A 70-year-old homebound patient was experiencing new onset porthostatic hypotension and lightheadedness. The pharmacist conducted a thorough medication review, which revealed the use of several herbal products, including St. John's wort, in addition to several prescription medications. The pharmacist counseled the patient on the potential hazards of using herbal products with prescription medications. This prompted the patient to discontinue all herbal supplements with the subsequent resolution of his lightheadedness and orthostasis. He also experienced improvement in his pain control. Pharmacists need to be vigilant in establishing a dialogue with their patients about the pros and cons of herbal product use, particularly with prescription medications.