Drug & supplement interaction

Rhodiola + Hydrocortisone

Hydrocortisone brand names: Cortef, Hydrocortone, Carmol HC cream, Hydrocortisone Iodoquinol Cream, Vytone Cream, and others.

Moderate Interaction
The bottom line Moderate

Hydrocortisone falls into 3 drug categories that Rhodiola can interact with; the most serious is rated moderate. Theoretically, rhodiola might increase levels of P-glycoprotein substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Rhodiola and Hydrocortisone

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Rhodiola interacts with whole categories of medication. Hydrocortisone falls into 3 of those categories, so it can interact with Rhodiola in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 3

Why this applies to Hydrocortisone

Hydrocortisone falls under P-GLYCOPROTEIN SUBSTRATES — the group Rhodiola interacts with.

Theoretically, rhodiola might increase levels of P-glycoprotein substrates.
In vitro research shows that rhodiola inhibits P-glycoprotein. Theoretically, using rhodiola with P-glycoprotein substrates might increase drug levels and potentially increase the risk of adverse effects.
Severity Moderate 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 combining Rhodiola with hydrocortisone. Your body uses a kind of cellular bouncer called P-glycoprotein to move certain drugs out of cells. Lab tests suggest Rhodiola may slow that bouncer down. In theory, that could let a bit more hydrocortisone hang around, nudging its effects up slightly.

If that happened, you might notice more typical steroid side effects, like fluid retention, a higher blood sugar reading, trouble sleeping, mood changes, or stomach upset. But I want to be honest: this concern comes only from test-tube research, not from people, so it's quite uncertain and likely minor for most folks. Still, since hydrocortisone matters for your hormone balance, run it by your pharmacist or doctor before adding Rhodiola.

References
  1. Hellum BH, Tosse A, Hoybakk K, et al. Potent in vitro inhibition of CYP3A4 and P-glycoprotein by Rhodiola rosea. Planta Med 2010;76:331-8.
Moderate

IMMUNOSUPPRESSANTS

2 of 3

Hydrocortisone also falls under IMMUNOSUPPRESSANTS.

Theoretically, rhodiola use might interfere with immunosuppressive therapy.
In vitro and animal research show that rhodiola has immunostimulatory effects.
Severity Moderate 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 idea behind this pairing. When hydrocortisone is being used to calm down an overactive immune system (think severe allergies, lupus, or certain inflammatory conditions), it works by quieting your immune response. Rhodiola, on the other hand, has shown immune-stimulating activity in lab dishes and animal studies. So in theory, rhodiola could nudge your immune system in the opposite direction and work against what hydrocortisone is trying to do, possibly making a flare-up harder to control.

I want to be honest with you though: this is a theoretical concern based only on early lab and animal research, not on real-world cases in people. If you're using hydrocortisone simply for low cortisol levels or as a skin cream, this is even less of a worry. Before adding rhodiola, just run it by your pharmacist or doctor so they can weigh in for your situation.

References
  1. Skopriska-Rozewska E, Wojcik R, Siwicki AK, et al. The effect of Rhodiola quadrifida extracts on cellular immunity in mice and rats. Pol J Vet Sci 2008;11:105-11.
  2. Mishra KP, Chanda S, Shukla K, Ganju L. Adjuvant effect of aqueous extract of Rhodiola imbricate rhizome on the immune responses to tetanus toxoid and ovalbumin in rats. Immunopharmacol Immunotoxicol 2010;32:141-6.
  3. Li HX, Sze SC, Tong Y, Ng TB. Production of Th1- and Th2-dependent cytokines induced by the Chinese medicine herb, Rhodiola algida, on human peripheral blood monocytes. J Ethnopharmacol 2009;123:257-66. PubMed
  4. Mishra KP, Ganju L, Chanda S, et al. Aqueous extract of Rhodiola imbricate rhizome stimulates Toll-like receptor 4, granzyme-B and Th1 cytokines in vitro. Immunobiology 2009;214:27-31.
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

Hydrocortisone also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, rhodiola might increase levels of drugs metabolized by CYP3A4.
In vitro research shows that rhodiola inhibits CYP3A4. This effect is highly variable and appears to be dependent on the rhodiola product studied. However, a clinical study in healthy young males found that taking rhodiola extract 290 mg daily for 14 days does not inhibit the metabolism of midazolam, a CYP3A4 substrate.
Severity Minor Likelihood Possible Evidence B

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: your body clears hydrocortisone partly through a liver enzyme called CYP3A4. In a test tube, rhodiola can slow that enzyme down, which in theory could let hydrocortisone build up a bit and slightly raise the chance of steroid-type effects like fluid retention, higher blood sugar, mood changes, or trouble sleeping.

I want to be honest about how shaky this is. It's rated a minor interaction, and a real human study found rhodiola didn't actually block this enzyme much. So for most people taking hydrocortisone, this is unlikely to cause a noticeable problem. Still, since rhodiola products vary a lot, it's smart to run it past your pharmacist or doctor before combining them, especially if you take hydrocortisone daily.

References
  1. Hellum BH, Tosse A, Hoybakk K, et al. Potent in vitro inhibition of CYP3A4 and P-glycoprotein by Rhodiola rosea. Planta Med 2010;76:331-8.
  2. Thu OK, Nilsen OG, Hellum B. In vitro inhibition of cytochrome P-450 activities and quantification of constituents in a selection of commercial Rhodiola rosea products. Pharm Bio. 2016 Dec;54(12):3249-3256.
  3. Thu OK, Spigset O, Nilsen OG, Hellum B. Effect of commercial Rhodiola rosea on CYP enzyme activity in humans. Eur J Clin Pharmacol. 2016 Mar;72(3):295-300. PubMed

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

Rhodiola Also Interacts With Other Medications

Rhodiola has 623 moderate, 647 minor known drug interactions in our database — the Hydrocortisone one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Rhodiola

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

From our Q&A

Questions About Rhodiola or Hydrocortisone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Rhodiola or Hydrocortisone, 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 Hydrocortisone

This page covers Rhodiola only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydrocortisone page lists 205 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lily-of-the-valley (major), St. John's Wort (major) and Acacia Rigidula (moderate).

By severity: 4 major · 164 moderate · 37 minor.

Open the Hydrocortisone interaction page

One more smart check

Taking Rhodiola as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2,713 real supplement products containing Rhodiola, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rhodiola. Your product may carry other ingredients that interact with Hydrocortisone too, on top of Rhodiola — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Rhodiola and Hydrocortisone 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 Rhodiola
Top 5%

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

29 days ago today
Medication Hydrocortisone
Top 25%

#447 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 Rhodiola

What is Rhodiola?

Rhodiola
  • Fatigue and low energy
  • Stress and coping (adaptogen)
  • Mental performance and focus
  • Mild depression
  • Physical and exercise performance

Rhodiola is an herb traditionally used to fight fatigue and help the body cope with stress. Some small studies suggest it may modestly reduce fatigue and improve mood, but the evidence is limited and not strong. It is generally well tolerated for short-term use, but talk to your pharmacist or doctor before trying it, and avoid it during pregnancy and breastfeeding.

Read the full Rhodiola monograph & all interactions
Medication

About Hydrocortisone

What Is Hydrocortisone Used For?

Brand names: Cortef, Hydrocortone, Carmol HC cream, Hydrocortisone Iodoquinol Cream, Vytone Cream, Massengil Medicated Towelettes, Dioderm, Efcortelan Cream, Mildison, Alphaderm, Calmurid HC, Efcortelan Ointment, Texacort, Alkindi Sprinkle

Hydrocortisone is used to calm skin inflammation and relieve itching caused by conditions that respond to corticosteroid treatment. In adults, it treats a broad range of inflammatory skin conditions. In children as young as 3 months old, it is specifically approved for mild to moderate atopic dermatitis (eczema).

It is also used in rectal foam form to treat inflammation of the lower bowel, such as ulcerative proctitis.

See full Hydrocortisone drug information
Keep checking

Other Drugs & Rhodiola

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

0Major
623Moderate
647Minor
1,559No known interaction
Moderate

623 interactions

Showing 60 of 623 moderate interactions — see all 623 on the Rhodiola page.

Minor

647 interactions

Showing 60 of 647 minor interactions — see all 647 on the Rhodiola page.

No interaction 1,559 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 Rhodiola and Hydrocortisone Together: Common Questions

Can you take Rhodiola with Hydrocortisone?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Rhodiola and Hydrocortisone?
Hydrocortisone belongs to more than one drug category, and Rhodiola interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Rhodiola and Hydrocortisone interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Hydrocortisone and Rhodiola?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.