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

Guía de interacción de medicamentos

Taking St John's Wort with fluoxetine can lead to a very serious and potentially life-threatening condition called 'serotonin syndrome'. This happens when there is too much of a chemical called serotonin in your brain. Symptoms can include feeling very agitated, confused, or shaky. You might also experience sweating, a fast heartbeat, muscle twitches, shivering, or diarrhoea. In severe cases, it can lead to fits (seizures) or loss of consciousness.

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Por qué sucede esto

Both fluoxetine and St John's Wort work by increasing the levels of serotonin in the brain. When used together, they can raise these levels too high (a 'pharmacodynamic' interaction). Additionally, St John's Wort can change how the liver breaks down certain medicines, which can make the levels of fluoxetine in your blood unpredictable.

Do NOT take St John's Wort if you are already taking fluoxetine (Prozac). If you are currently taking both, you should contact your GP or pharmacist immediately for advice before stopping either, as stopping antidepressants suddenly can also cause side effects. If you experience severe symptoms like confusion, high fever, or tremors, seek emergency medical help.

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Síndrome de serotonina

Taking fluoxetine and St John's wort together significantly increases the risk of serotonin syndrome, a potentially life-threatening condition caused by excessive serotonin levels. Symptoms include high fever, agitation, confusion, and muscle twitching. Do not combine these treatments.

Depresión y Salud Mental

Like other antidepressants, St John's wort and fluoxetine may increase the risk of suicidal thoughts or self-harm, particularly when first starting treatment. Seek immediate medical help if your mood worsens.

Interacciones con medicamentos

La hierba de San Juan reduce significativamente la eficacia de muchos medicamentos esenciales, incluyendo la píldora anticonceptiva, los anticoagulantes (warfarina), los medicamentos para la epilepsia y los fármacos para trasplantes de órganos. No la comiences sin que un farmacéutico verifique tus medicamentos actuales.

Riesgo de sangrado

Fluoxetine can increase your risk of bleeding, especially if you are also taking aspirin, NSAIDs (like ibuprofen), or blood-thinning medications (like warfarin). Seek medical advice if you notice unusual bruising or bleeding.

Fotosensibilidad

La hierba de San Juan puede hacer que su piel sea mucho más sensible a la luz solar, lo que puede provocar quemaduras solares graves o reacciones cutáneas incluso con una exposición limitada.

Alcohol

It is best to avoid or strictly limit alcohol while taking these medicines. Combining alcohol with fluoxetine or St John's Wort can increase drowsiness and dizziness, and may worsen feelings of depression.

Cafeína (Café, Té, Bebidas Energéticas)

Fluoxetine can increase the effects of caffeine in your body. This may lead to feeling jittery, anxious, or having difficulty sleeping.

Foods high in Tyramine (e.g., aged cheeses, cured meats, soy sauce, marmite, overripe fruit)

While less common than with older prescription antidepressants, St John's Wort can potentially interact with tyramine-rich foods, leading to a sudden, dangerous increase in blood pressure (hypertensive crisis). You should consume these foods in moderation.

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Taking multiple medicines? Our Verificador de Interacciones 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.

Descargo de responsabilidad

Esta información es solo para fines educativos generales y no debe considerarse como un sustituto del consejo médico profesional. Siempre consulte a su médico de cabecera, farmacéutico u otro profesional de la salud calificado antes de tomar decisiones sobre sus medicamentos. Las circunstancias individuales pueden variar, y solo un profesional de la salud que conozca su historial médico puede proporcionar orientación personalizada.

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Historial del artículo

La información en esta página está escrita y revisada por pares por clínicos calificados.

  • 25 Ene 2026 | Publicado originalmente
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