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

Non assumere Iperico 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.

Perché succede

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:

• Ti senti agitato, irrequieto o insolitamente ansioso.

• Si verificano confusione o cambiamenti nello stato mentale.

• Noti tremori, contrazioni muscolari o tremori.

• Hai sudorazione eccessiva, arrossamento o febbre.

• Sviluppi un battito cardiaco veloce o irregolare.

• You experience diarrhoea or nausea.

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

Se hai uno dei sintomi sopra elencati, dovresti:

• Contatta immediatamente il tuo medico di base o il farmacista per un consiglio.

• 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.

• Informa il tuo professionista sanitario su tutti gli altri medicinali e integratori che stai assumendo.

Sindrome serotoninergica

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 sindrome serotoninergica. Symptoms include shivering, diarrhoea, confusion, and severe muscle stiffness.

Suicidal thoughts and self-harm

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.

Aumento del rischio di sanguinamento

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 warfarin. This can lead to unplanned pregnancy or an increased risk of blood clots.

Alcol

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.

Succo di pompelmo

Evita di bere grandi quantità di succo di pompelmo. Il pompelmo contiene composti che possono aumentare i livelli di sertralina nel sangue, il che potrebbe aumentare il rischio di effetti collaterali.

Caffeina (Caffè, Tè, Bevande Energetiche)

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.

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Avvertenza

Queste informazioni sono solo a scopo educativo generale e non devono essere considerate un sostituto del consiglio medico professionale. Consultate sempre il vostro medico di base, farmacista o un altro professionista sanitario qualificato prima di prendere decisioni sui vostri farmaci. Le circostanze individuali possono variare, e solo un professionista sanitario che conosce la vostra storia medica può fornire una guida personalizzata.