The short answer
Discuss St John’s wort with the prescriber before adding it to amoxapine. General antidepressant precautions support review, but an exact amoxapine serotonin-syndrome interaction has not been established.
What this answer covers
Oral Hypericum perforatum with amoxapine tablets; no assumed equivalence to other antidepressants.
- Supplement or preparation
- Hypericum perforatum
- Medication ingredient
- amoxapine
What the herb guidance says
NCCIH warns that St John’s wort with certain antidepressants may cause serious serotonin-related effects. It does not provide an amoxapine-specific result.
Use the exact medicine information
Amoxapine’s label describes a mild sedative component and dopamine-receptor effects. It does not explicitly give the St John’s wort warning found in some other antidepressant labels.
Review before changing the regimen
Bring the exact herb and dose to the prescriber. No validated time gap or self-directed medicine adjustment is established for this combination.
Recognize a serious change
New high fever, marked muscle rigidity or confusion needs urgent assessment. Amoxapine has a neuroleptic malignant syndrome warning; these symptoms should not automatically be labeled a supplement-induced serotonin interaction.
Evidence and practical considerations
Side effects & toxicity
Supervised review is reasonable; exact-pair serotonin-syndrome claim remains insufficient.
- Exact scope
- Oral Hypericum perforatum with amoxapine tablets; no assumed equivalence to other antidepressants. with Exact oral amoxapine tablets. RxNorm IN722, exact oral amoxapine tablets. Active hydroxy metabolites and dopamine-receptor effects do not make it identical to other antidepressants or antipsychotics.
- Medication form and route
- oral
- Timing or duration
- Source-specific single-dose, repeated-dose and observational exposures distinguished.
What remains uncertain
- US amoxapine label does not explicitly name St John’s wort or serotonin syndrome. General guidance does not establish a case or safe interval.
Factors that may matter: preparation and plant part; clinical indication; dose; other medicines; baseline alertness.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed oral amoxapine.
Label describes a mild sedative component, dopamine-blocking and neuroleptic malignant syndrome concerns, and active metabolites. It does not explicitly name serotonin syndrome or the requested supplements.
How this applies: RxNorm IN722, exact oral amoxapine tablets. Active hydroxy metabolites and dopamine-receptor effects do not make it identical to other antidepressants or antipsychotics.
No universal supplement interval, event rate or preparation equivalence established.
Source 2: official botanical guidance
nccih.nih.gov · Source check Sep 10, 2026
Population: Users of Hypericum perforatum.
Certain antidepressant combinations may cause serious serotonin-related side effects; herb can reduce the effects of some medicines.
How this applies: Supplement guidance supports review; exact amoxapine clinical interaction remains unestablished.
General product precaution, not a quantified amoxapine-specific interaction or clinical case.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Current exact available claims adjudicated using original captures and explicit identity and comparator limits. | |
| Research summary published |
Article revision: 4bc66b367bd6efc3
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.