The short answer
Sertraline labeling specifically warns about St John’s wort and serotonin syndrome. Discuss any use with the prescriber before combining them.
What this answer covers
Oral Hypericum perforatum with sertraline hydrochloride tablets.
- Supplement or preparation
- Hypericum perforatum
- Medication ingredient
- sertraline
The label names St John’s wort
Sertraline’s own prescribing information includes the herb among serotonergic products that can increase serotonin-syndrome risk.
Case reports have an access limit
An original elderly case series reported serotonin-related illness after St John’s wort with antidepressants. The accessible abstract does not identify each medicine, so it cannot establish a sertraline-specific event count.
Comparison trials do not test taking both
A trial compared St John’s wort, sertraline and placebo in separate groups. Its results do not establish safe combination use or a protective dose gap.
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 review; original reports and trials have explicit access and comparator boundaries.
- Exact scope
- Oral Hypericum perforatum with sertraline hydrochloride tablets. with Exact oral sertraline hydrochloride tablets. RxNorm IN36437 / PIN155137 hydrochloride tablets. Oral concentrate and its specific diluent instructions are distinct.
- Medication form and route
- oral
- Timing or duration
- Source-specific single-dose, repeated-dose and observational exposures distinguished.
What remains uncertain
- Restricted case-series methods prevent exact sertraline attribution from that source; comparative trials do not test co-use.
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 sertraline.
Label names tryptophan and St John’s wort in serotonin warnings and describes bleeding precautions. Tablet scope; grapefruit juice data do not automatically establish flesh equivalence.
How this applies: RxNorm IN36437 / PIN155137 hydrochloride tablets. Oral concentrate and its specific diluent instructions are distinct.
No universal supplement interval, event rate or preparation equivalence established.
Source 2: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Five elderly patients in original case series.
Clinically diagnosed central serotonergic syndrome was reported.
How this applies: Only the named drug, preparation, route and measured endpoints apply.
Accessible abstract does not identify individual antidepressants; restricted publisher methods prevent confirmation of sertraline exposure here.
Source 3: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 340 adults with major depression.
Neither active treatment differed from placebo on the two primary outcomes; sertraline improved a secondary measure.
How this applies: Only the named drug, preparation, route and measured endpoints apply.
Separate treatments, not combined exposure; no conclusion about safe co-use.
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: cb5547631b038e0c
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.