Sertraline and St Johns Wort: Drug Interaction Guide

Quick answer: This is a major interaction — avoid combining Sertraline and St Johns Wort unless specifically directed by your doctor.

Interaction severity: Major — avoid combination

How Sertraline interacts with St Johns Wort

St John's wort has serotonergic activity and induces CYP enzymes and P-glycoprotein. With sertraline, it can increase serotonin syndrome risk and unpredictably alter drug exposure.

What you should do

Avoid concurrent use. Ask specifically about herbal medicines and allow an appropriate washout before starting serotonergic antidepressants.

Key facts

Severity

Major — avoid combination

Mechanism

St John's wort has serotonergic activity and induces CYP enzymes and P-glycoprotein. With sertraline, it can increase se...

Action

Avoid concurrent use. Ask specifically about herbal medicines and allow an appropriate washout before starting serotoner...

Important medical disclaimer: This page provides educational information about drug interactions for general reference. It is not a substitute for professional medical advice, diagnosis, or treatment. Always discuss your specific medications with a qualified healthcare provider before starting, stopping, or changing any treatment. About our editorial team.

Frequently asked questions

Can I take Sertraline and St Johns Wort together?

No — this combination should generally be avoided. Avoid concurrent use. Ask specifically about herbal medicines and allow an appropriate washout before starting serotonergic antidepressants.

What is the severity of this interaction?

The interaction between Sertraline and St Johns Wort is classified as Major — avoid combination. St John's wort has serotonergic activity and induces CYP enzymes and P-glycoprotein. With sertraline, it can increase serotonin syndrome risk and unpredictably alter drug exposure.

What should I do if I'm prescribed both?

Avoid concurrent use. Ask specifically about herbal medicines and allow an appropriate washout before starting serotonergic antidepressants. Always consult your prescribing clinician — do not stop or change medications without medical guidance.

Last reviewed: by iMedic Medical Editorial Team. Our editorial process.