Rhodiola Rosea and medications.
Rhodiola Rosea is in the Distil supplement database, evidence Grade B. The page below lists every medication we have explicitly assessed it against.
Rhodiola rosea is an adaptogen aimed at mental fatigue and stress resilience, with Grade B evidence for reducing fatigue, supporting mood, and helping endurance performance. Hung 2011 and Darbinyan 2007 are the better trials, using a standardised SHR-5 extract. The usual dose is 200 to 400mg standardised to 3% rosavins and 1% salidroside. There is an important caveat: rhodiola can worsen anxiety, so it suits burnout and recovery rather than someone who is already anxious, and anxiety should be assessed before it goes in a stack. The interactions need care. It carries a serotonin syndrome risk with SSRIs and MAOIs and should be excluded if an SSRI is present. It is also best avoided in bipolar disorder without psychiatric oversight, because a stimulating, mood-elevating adaptogen can occasionally tip someone toward mania or hypomania. It should never be started at the same time as ashwagandha; stagger them by at least four weeks so you can tell what is doing what. Take it in the morning, since later doses can disrupt sleep, and cycle twelve weeks on, four weeks off. For burnout specifically, it tends to help.
Below are the 29 documented pairs we have explicitly assessed for Rhodiola Rosea: 7 red and 22 amber. The pairs cluster around 2 mechanisms: Additive serotonergic activity and Additive sympathomimetic activity. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.
Documented interactions
Last reviewed 30 June 2026. Each interaction below is assessed against PubMed-indexed evidence.
Additive serotonergic activity
Red Does interact with Isocarboxazid?
Rhodiola appears to slow the same enzyme (monoamine oxidase) that isocarboxazid blocks. Stacking the two could push serotonin and related signals too high, risking serotonin syndrome or a dangerous rise in blood pressure. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does interact with Linezolid?
Rhodiola appears to slow the same enzyme (monoamine oxidase) that linezolid blocks, and adds its own serotonin activity. Stacking the two could push serotonin too high, risking serotonin syndrome. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does interact with Moclobemide?
Rhodiola appears to slow the same enzyme (monoamine oxidase) that moclobemide blocks, and adds its own serotonin activity. Stacking the two could push serotonin too high, risking serotonin syndrome. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does interact with Phenelzine?
Rhodiola appears to slow the same enzyme (monoamine oxidase) that phenelzine blocks. Stacking the two could push serotonin and related signals too high, risking serotonin syndrome or a dangerous rise in blood pressure. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does interact with Rasagiline?
Rasagiline is an MAO-B inhibitor used for Parkinson's, and rhodiola appears to slow monoamine oxidase too. Stacking them could push serotonin too high, risking serotonin syndrome. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does interact with Selegiline?
Selegiline is an MAO-B inhibitor used for Parkinson's, and rhodiola appears to slow monoamine oxidase too. Stacking them could push serotonin too high, risking serotonin syndrome. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does interact with Tranylcypromine?
Rhodiola appears to slow the same enzyme (monoamine oxidase) that tranylcypromine blocks. Stacking the two could push serotonin and related signals too high, risking serotonin syndrome or a dangerous rise in blood pressure. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Amitriptyline?
Rhodiola has a mild effect on serotonin pathways, and amitriptyline raises serotonin as part of how it works. In theory, taking them together could add to that effect. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Citalopram?
Rhodiola has mild effects on serotonin pathways that can add to citalopram's. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Clomipramine?
Rhodiola has a mild effect on serotonin pathways, and clomipramine is the tricyclic that raises serotonin most strongly. In theory, taking them together could add to that serotonin effect. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Dosulepin?
Rhodiola has a mild effect on serotonin pathways, and dosulepin raises serotonin as part of how it works. In theory, taking them together could add to that effect. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Doxepin?
Rhodiola has a mild effect on serotonin pathways, and doxepin can raise serotonin as part of how it works. In theory, taking them together could add to that effect. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Duloxetine hydrochloride?
Rhodiola has mild effects on serotonin pathways, and duloxetine raises serotonin as part of how it works. Taking them together may add to that effect. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Escitalopram?
Rhodiola has mild effects on serotonin pathways that can add to escitalopram's. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Fluoxetine hydrochloride?
Rhodiola has mild effects on serotonin pathways that can add to fluoxetine's. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Fluvoxamine?
Rhodiola has mild effects on serotonin pathways that can add to fluvoxamine's. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Imipramine?
Rhodiola has a mild effect on serotonin pathways, and imipramine raises serotonin as part of how it works. In theory, taking them together could add to that effect. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Lithium carbonate?
Rhodiola has a mild effect on serotonin pathways, and lithium can add to serotonin activity in the brain. In theory, taking them together could add to that effect. Lithium also has a narrow safe range, so it is worth telling the doctor who manages your lithium before you start rhodiola, watching for restlessness, sweating, tremor, or a racing heart, and keeping to your usual lithium blood tests.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Paroxetine hydrochloride?
Rhodiola has mild effects on serotonin pathways that can add to paroxetine's. The one published case of this kind of reaction involved rhodiola taken alongside paroxetine, so this is the best-documented pair. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Sertraline?
Rhodiola has mild effects on serotonin pathways that can add to sertraline's. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Sumatriptan succinate?
Rhodiola has mild effects on serotonin pathways, and sumatriptan is a serotonin-receptor drug used for migraine, so in theory taking them together could add to that serotonin effect. The real-world risk looks low and most people tolerate it, but it is worth mentioning the rhodiola to your GP, especially if you also take an antidepressant. If you notice restlessness, sweating, tremor, or a racing heart, stop and seek advice.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Tramadol hydrochloride?
Rhodiola has mild effects on serotonin pathways, and tramadol raises serotonin as part of how it relieves pain. Taking them together may increase the risk of serotonin syndrome. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your prescriber before stacking them, especially if your tramadol dose has recently changed.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Trazodone hydrochloride?
Rhodiola has a mild effect on serotonin pathways, and trazodone raises serotonin as part of how it works. In theory, taking them together could add to that effect. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Venlafaxine?
Rhodiola has mild effects on serotonin pathways, and venlafaxine raises serotonin as part of how it works. Taking them together may add to that effect. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Vortioxetine?
Rhodiola has a mild effect on serotonin pathways, and vortioxetine raises serotonin as part of how it works. In theory, taking them together could add to that effect. Most people tolerate the combination, but watch for restlessness, sweating, tremor, or a racing heart, and talk to your GP before stacking them, especially if your dose has recently changed.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Zolmitriptan?
Rhodiola has mild effects on serotonin pathways, and zolmitriptan is a serotonin-receptor drug used for migraine, so in theory taking them together could add to that serotonin effect. The real-world risk looks low and most people tolerate it, but it is worth mentioning the rhodiola to your GP, especially if you also take an antidepressant. If you notice restlessness, sweating, tremor, or a racing heart, stop and seek advice.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Additive sympathomimetic activity
Amber Does interact with Dexamfetamine sulfate?
Rhodiola is a mildly stimulating herb, and dexamfetamine is a stimulant for ADHD. Taken together they could add up, so you might notice more jitteriness, a faster heartbeat, raised blood pressure, anxiety, or trouble sleeping. If you want to use both, start rhodiola low, watch how you respond, and tell the person who prescribes your dexamfetamine.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Lisdexamfetamine dimesylate?
Rhodiola is a mildly stimulating herb, and lisdexamfetamine is a stimulant for ADHD. Taken together they could add up, so you might notice more jitteriness, a faster heartbeat, raised blood pressure, anxiety, or trouble sleeping. If you want to use both, start rhodiola low, watch how you respond, and tell the person who prescribes your lisdexamfetamine.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Methylphenidate hydrochloride?
Rhodiola is a mildly stimulating herb, and methylphenidate is a stimulant for ADHD. Taken together they could add up, so you might notice more jitteriness, a faster heartbeat, raised blood pressure, anxiety, or trouble sleeping, or your usual stimulant dose may feel different. If you want to use both, start rhodiola low, watch how you respond, and tell the person who prescribes your methylphenidate.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.
No affiliates. No commission. We earn nothing on what you buy.
How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyWant this checked across everything you take?
This page checks the pairs you enter. The personalised Distil report goes further:
- the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
- where your current routine may be leaving you short of your goals
- the evidence-graded compounds worth adding, and the ones worth dropping
It's a paid report: £79, or £49 founder pricing while we earn our first reviews. The interactions check is one section of it, and you can read a real one in full before you decide.
See a real sample reportSomething missing?
If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.