Drug interactions
Rizatriptan + St john's wort
Severity: Moderate
Rizatriptan and St john's wort: moderate 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 combining it with a triptan may increase the chance of serotonin syndrome. Reports are limited, but the herbal product is not standardized and its effects vary.
What this interaction means in plain words
Rizatriptan and St john's wort can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive serotonergic effects from triptan agonism and St John's wort inhibition of monoamine reuptake.
What to do
Advise patients to avoid the herbal product while using triptans, or monitor for serotonin syndrome if combined. Stop the herb if symptoms occur.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Rizatriptan
- Almotriptan + Rizatriptan Contraindicated
- Dihydroergotamine intranasal + Rizatriptan Contraindicated
- Dihydroergotamine + Rizatriptan Contraindicated
- Eletriptan + Rizatriptan Contraindicated
- Ergoloid mesylates + Rizatriptan Contraindicated
- Ergotamine + Rizatriptan Contraindicated
Frequently asked questions
Can I take Rizatriptan with St john's wort?
MediHelp rates the interaction as moderate. Rizatriptan and St john's wort can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. St John's wort has serotonergic activity and combining it with a triptan may increase the chance of serotonin syndrome. Reports are limited, but the herbal product is not standardized and its effects vary.
How serious is the interaction between Rizatriptan and St john's wort?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid the herbal product while using triptans, or monitor for serotonin syndrome if combined. Stop the herb if symptoms occur.
What other medicines interact with Rizatriptan?
MediHelp also lists interactions of Rizatriptan with, for example, Almotriptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Rizatriptan page.
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