Drug interactions
Rasagiline + St john's wort
Severity: Major
Rasagiline and St john's wort: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
St John's wort has serotonergic activity, and combination with an MAO inhibitor may lead to serotonin syndrome. Symptoms include agitation, tremor, hyperthermia and autonomic instability.
What this interaction means in plain words
Rasagiline and St john's wort can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
St John's wort inhibits reuptake of serotonin and other monoamines, adding to the increased serotonin from MAO inhibition.
What to do
Avoid the combination and stop St John's wort before starting rasagiline. Monitor for signs of serotonin toxicity if exposure occurs.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Rasagiline
- Atomoxetine + Rasagiline Contraindicated
- Brimonidine + Rasagiline Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
- Bupropion + Rasagiline Contraindicated
- Clomipramine + Rasagiline Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
Frequently asked questions
Can I take Rasagiline with St john's wort?
MediHelp rates the interaction as major. Rasagiline and St john's wort can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. St John's wort has serotonergic activity, and combination with an MAO inhibitor may lead to serotonin syndrome. Symptoms include agitation, tremor, hyperthermia and autonomic instability.
How serious is the interaction between Rasagiline and St john's wort?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and stop St John's wort before starting rasagiline. Monitor for signs of serotonin toxicity if exposure occurs.
What other medicines interact with Rasagiline?
MediHelp also lists interactions of Rasagiline with, for example, Atomoxetine, Brimonidine, Bupropion-naltrexone. The full list is on the Rasagiline page.
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