Can I take St John's wort and Sertraline together?

Não tome erva de São João if you are already taking sertralina.

If you are currently taking both, you should contact your GP or pharmacist immediately for advice before stopping either medication, as stopping antidepressants suddenly can also cause side effects.

Por que isso acontece

Both sertraline and St John's wort work by increasing the levels of serotonin in the brain. When used at the same time, they have an 'additive effect', pushing serotonin levels far too high.

Additionally, St John's wort can change how the liver breaks down certain medicines, which can make the levels of sertraline in your blood unpredictable.

You may be experiencing an interaction between St John's wort and sertraline if:

• Você se sente agitado, inquieto ou incomumente ansioso.

• Você experimenta confusão ou mudanças no estado mental.

• Você percebe tremores, contrações musculares ou tremores.

• Você tem suor excessivo, rubor ou febre.

• Você desenvolve um batimento cardíaco rápido ou irregular.

• You experience diarrhoea or nausea.

• Symptoms start soon after starting, combining, or increasing the dose of either product.

Se você tiver algum dos sintomas acima, você deve:

• Entre em contato com seu médico ou farmacêutico imediatamente para obter aconselhamento.

• Seek urgent medical help if you develop high fever, confusion, severe agitation, or a fast heartbeat.

• Do not stop sertraline suddenly unless advised by a healthcare professional.

• Stop taking St John’s wort and inform your healthcare professional that you have been using it.

• Informe o seu profissional de saúde sobre todos os outros medicamentos e suplementos que você está tomando.

Síndrome serotoninérgica

Do not take St John's wort and sertraline together. Combining them can cause dangerously high levels of serotonin, leading to a life-threatening condition called síndrome serotoninérgica. Symptoms include shivering, diarrhoea, confusion, and severe muscle stiffness.

Pensamentos suicidas e automutilação

Antidepressants like sertraline and St John's wort can increase the risk of suicidal thoughts or self-harm, particularly in the first few weeks of treatment or when the dose is changed. Patients and carers should monitor for any changes in mood or behaviour and seek urgent medical help if these occur.

Risco aumentado de sangramento

Sertraline can increase the risk of bleeding, especially if you are taking other medicines that affect blood clotting, such as aspirin, ibuprofen (NSAIDs), or warfarin. Seek medical advice if you notice unusual bruising or bleeding.

Drug Interactions

St John's wort makes many essential medicines less effective, including the contraceptive pill and blood thinners such as varfarina. This can lead to unplanned pregnancy or an increased risk of blood clots.

Álcool

It is best to avoid or strictly limit alcohol while taking these medicines. Combining alcohol with sertraline or St John's Wort can increase drowsiness, dizziness, and impair your coordination. There is also a risk that alcohol may worsen your symptoms of depression or anxiety.

Suco de toranja

Evite beber grandes quantidades de suco de toranja. A toranja contém compostos que podem aumentar os níveis de sertralina no seu sangue, o que pode aumentar o risco de efeitos colaterais.

Cafeína (Café, Chá, Bebidas Energéticas)

St John's Wort can sometimes increase sensitivity to caffeine, leading to feelings of restlessness, anxiety, or a racing heart. Monitor your intake if you feel jittery.

Foods high in tyramine

While the risk is lower than with older types of antidepressants, some people taking St John's wort may experience a rise in blood pressure if they consume very large amounts of foods high in tyramine (e.g., aged cheeses, cured meats, fermented products). Use these foods in moderation.

Taking multiple medicines? Our Verificador de Interações de Medicamentos helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Aviso Legal

Esta informação é apenas para fins educacionais gerais e não deve ser considerada como um substituto para aconselhamento médico profissional. Sempre consulte seu médico, farmacêutico ou outro profissional de saúde qualificado antes de tomar decisões sobre seus medicamentos. As circunstâncias individuais podem variar, e somente um profissional de saúde que conheça seu histórico médico pode fornecer orientações personalizadas.