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Supplement · Grade B

Rhodiola Rosea and medications.

Every documented pair, every citation. Below: 5 documented pairs grouped by mechanism.

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 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 5 documented pairs we have explicitly assessed for Rhodiola Rosea: 1 red and 4 amber. The pairs cluster around 1 mechanism: Additive serotonergic 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

Additive serotonergic activity

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.

PMID 19168123 · PMID 25413939 · PMID 30659561 · BNF: Phenelzine

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Amber 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.

PMID 19168123 · PMID 25413939 · PMID 30659561 · BNF: Citalopram

Reviewer-flagged: awaiting clinical-reviewer sign-off.

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.

PMID 19168123 · PMID 25413939 · PMID 30659561 · BNF: Fluoxetine

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Amber 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.

PMID 19168123 · PMID 25413939 · PMID 30659561 · BNF: Sertraline

Reviewer-flagged: awaiting clinical-reviewer sign-off.

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.

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.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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How we decide

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 methodology
Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.