The short answer
Citalopram labeling specifically warns about St John’s wort and serotonin syndrome. Review any intended use with the prescriber.
What this answer covers
Oral Hypericum perforatum with citalopram hydrobromide tablets.
- Supplement or preparation
- Hypericum perforatum
- Medication ingredient
- citalopram
The warning names this herb
The citalopram label includes St John’s wort among serotonergic products that can increase serotonin-syndrome risk.
Natural origin does not remove the warning
Tell the prescriber about the extract, dose and all mood products. The label warning does not establish that every extract produces the same exposure.
Review starting and stopping
Do not add the herb or change citalopram to manage the combination yourself. A gap between doses is not established protection.
Recognize concerning symptoms
Seek urgent medical care for a combination of agitation or confusion, fever or heavy sweating, tremor, muscle rigidity or repeated twitching. These can be signs of serotonin syndrome; a single nonspecific symptom does not establish the diagnosis.
Evidence and practical considerations
Side effects & toxicity
Exact-label serotonergic precaution supports individual review.
- Exact scope
- Oral Hypericum perforatum with citalopram hydrobromide tablets. with Exact oral citalopram hydrobromide film-coated tablets. RxNorm IN2556 / PIN221078 hydrobromide tablets. Racemic citalopram is distinct from escitalopram.
- Medication form and route
- oral
- Timing or duration
- Source-specific single-dose, repeated-dose and observational exposures distinguished.
What remains uncertain
- No exact-pair incidence or universally safe herb dose or spacing established.
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 citalopram.
Label names tryptophan and St John’s wort in serotonin warnings; dose-dependent QT and electrolyte precautions are distinct from sedation and nutritional augmentation.
How this applies: RxNorm IN2556 / PIN221078 hydrobromide tablets. Racemic citalopram is distinct from escitalopram.
No universal supplement interval, event rate or preparation equivalence established.
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: 0d91d51a4c9fe7f1
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.