Drug & supplement interaction

Hibiscus Sabdariffa + Paroxetine

Paroxetine brand names: Paxil CR, Paxil, Brisdelle.

Minor Interaction
The bottom line Minor

Hibiscus Sabdariffa has a minor interaction with Paroxetine. Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2D6 substrates.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Hibiscus Sabdariffa and Paroxetine

Here is the interaction we found between these two, with the evidence behind it.

Minor

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

Why this applies to Paroxetine

Paroxetine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Hibiscus Sabdariffa interacts with.

Theoretically, Hibiscus sabdariffa extract might reduce the metabolism of CYP2D6 substrates.
In vitro research shows that Hibiscus sabdariffa calyx extract inhibits CYP2D6. This interaction has not been reported in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for paroxetine (Paxil, Brisdelle). Your body relies on a liver enzyme called CYP2D6 to help clear this medicine. In lab dish studies, concentrated hibiscus extract slowed that same enzyme down. If that happened in real life, paroxetine could build up a bit more than usual, which might mean stronger side effects like drowsiness, nausea, dry mouth, sweating, or trouble sleeping.

The important part: this is purely theoretical, based on test-tube work, and has never actually been reported in people. The occasional cup of tart hibiscus tea is very unlikely to be a problem. I'd only raise an eyebrow with daily concentrated supplements. If you want to use hibiscus regularly, just give your pharmacist or doctor a quick heads-up first.

References
  1. Johnson SS, Oyelola FT, Ari T, Juho H. In vitro inhibitory activities of the extract of Hibiscus sabdariffa L. (family Malvaceae) on selected cytochrome P450 isoforms. Afr J Tradit Complement Altern Med. 2013 Apr 12;10(3):533-40.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Hibiscus Sabdariffa Also Interacts With Other Medications

Hibiscus Sabdariffa has 2 major, 266 moderate, 818 minor known drug interactions in our database — the Paroxetine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Hibiscus Sabdariffa

Covers the 2,830 medications we’ve checked against Hibiscus Sabdariffa. Pick one to open its full report.

From our Q&A

Questions About Hibiscus Sabdariffa or Paroxetine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Hibiscus Sabdariffa or Paroxetine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Paroxetine

This page covers Hibiscus Sabdariffa only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Paroxetine page lists 134 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Iboga (major), Lithium (major), 1,3-dmaa (moderate) and 5-htp (moderate).

By severity: 3 major · 105 moderate · 26 minor.

From our pharmacist’s overview on the Paroxetine page

“I treat paroxetine (Paxil, Paxil CR, Brisdelle) as a medication where supplement choices genuinely matter, not one to wave through. This antidepressant raises serotonin, so about twenty of the ingredients listed here, lithium among them, can push serotonin too high and risk serotonin syndrome, a dangerous reaction.”

Reviewed by 2 · Jul 18, 2026

Open the Paroxetine interaction page

How much people look this up

Where Hibiscus Sabdariffa and Paroxetine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Hibiscus Sabdariffa
Top half

#433 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Paroxetine
Top half

#1,192 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Hibiscus Sabdariffa

What is Hibiscus Sabdariffa?

Hibiscus Sabdariffa
  • High blood pressure
  • Heart and cholesterol health
  • Digestive upset
  • Antioxidant support
  • Fever and general wellness

Hibiscus sabdariffa is a tart, cranberry-flavored plant most often consumed as a tea, and its best-studied use is for mildly lowering blood pressure. Evidence for other uses is limited, and while hibiscus tea is generally well tolerated in food amounts, concentrated supplements should be used cautiously and avoided in pregnancy. Talk to your pharmacist or doctor before using it for a medical condition.

Read the full Hibiscus Sabdariffa monograph & all interactions
Medication

About Paroxetine

What Is Paroxetine Used For?

Brand names: Paxil CR, Paxil, Brisdelle

Paroxetine tablets, film-coated tablets, and oral suspensions are approved in adults for major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder, social anxiety disorder, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD). The extended-release tablet forms (Paxil CR, paroxetine HCL CR, and paroxetine extended-release tablets) are approved in adults for MDD, panic disorder, social anxiety disorder, and premenstrual dysphoric disorder (PMDD).

Brisdelle (paroxetine 7.5 mg capsule) and generic paroxetine capsules are approved specifically for moderate to severe vasomotor symptoms (hot flashes) associated with menopause — not for any psychiatric condition. Paroxetine tablets are not approved for use in children.

See full Paroxetine drug information
Keep checking

Other Drugs & Hibiscus Sabdariffa

Browse every other medication we’ve checked against Hibiscus Sabdariffa — both the ones with a known interaction and the ones without. Select any drug for the full detail.

2Major
266Moderate
818Minor
1,743No known interaction
Major

2 interactions

Moderate

266 interactions

Showing 60 of 266 moderate interactions — see all 266 on the Hibiscus Sabdariffa page.

Minor

818 interactions

Showing 60 of 818 minor interactions — see all 818 on the Hibiscus Sabdariffa page.

No interaction 1,743 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Hibiscus Sabdariffa and Paroxetine Together: Common Questions

Can you take Hibiscus Sabdariffa with Paroxetine?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Hibiscus Sabdariffa and Paroxetine interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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