St. John's Wort + Amitriptyline
Amitriptyline brand name: Elavil.
Amitriptyline falls into 6 drug categories that St. John's Wort can interact with; the most serious is rated major. St. John's wort increases the metabolism and reduces the levels of CYP3A4 substrates.
Read the full interaction reportSt. John's Wort and Amitriptyline
These two interact in 6 distinct ways. Each one is explained separately below.
Why Are There 6 Interactions?
St. John's Wort interacts with whole categories of medication. Amitriptyline falls into 6 of those categories, so it can interact with St. John's Wort in 6 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
1 of 6Why this applies to Amitriptyline
Amitriptyline falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group St. John's Wort interacts with.
St. John's wort induces CYP3A4 enzymes and increases metabolism of CYP3A4 substrates. Clinically significant interactions have been reported with St. John's wort products containing hyperforin 1 mg or more.
Interaction 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..
Here's the gist for amitriptyline (Elavil): St. John's wort speeds up a liver enzyme called CYP3A4, which is one of the pathways that breaks this medicine down. When that enzyme works faster, your body clears amitriptyline more quickly, so blood levels can drop and the medicine may not control your depression as well as it should.
There's a second worry worth mentioning. Both St. John's wort and amitriptyline raise serotonin, so combining them can also push serotonin too high, causing things like agitation, sweating, a racing heart, or shakiness. So you've got two opposite-direction risks here: weaker mood benefit plus a serotonin overload. Please don't start or stop either one on your own. Talk with your pharmacist or doctor first so they can guide you safely.
- Henderson L, Yue QY, Bergquist C, et al. St John's wort (Hypericum perforatum): drug interactions and clinical outcomes. Br J Clin Pharmacol 2002;54:349-56..
- Markowitz JS, Donovan JL, DeVane CL, et al. Effect of St. John's wort on drug metabolism by induction of cytochrome P450 3A4 enzyme. JAMA 2003;290:1500-4.. PubMed
- Gurley BJ, Gardner SF, Hubbard MA, et al. Cytochrome P450 phenotypic ratios for predicting herb-drug interactions in humans. Clin Pharmacol Ther 2002;72:276-87.. PubMed
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
- Komoroski BJ, Zhang S, Cai H, et al. Induction and inhibition of cytochromes P450 by the St. John's wort constituent hyperforin in human hepatocyte cultures. Drug Metab Dispos 2004;32:512-8. PubMed
- Smith M, Lin KM, and Zheng YP. PIII-89 an open trial of nifedipine-herb interactions: Nifedipine with St. John's wort, ginseng or ginkgo biloba. Clin Pharm Ther 2001;69:P86.
- Kawaguchi, A., Ohmori, M., Tsuruoka, S., Nishiki, K., Harada, K., Miyamori, I., Yano, R., Nakamura, T., Masada, M., and Fujimura, A. Drug interaction between St John's Wort and quazepam. Br.J.Clin Pharmacol. 2004;58(4):403-410. PubMed
- Dresser, G. K., Schwarz, U. I., Wilkinson, G. R., and Kim, R. B. Coordinate induction of both cytochrome P4503A and MDR1 by St John's wort in healthy subjects. Clin Pharmacol Ther 2003;73(1):41-50. PubMed
- Patel, J., Buddha, B., Dey, S., Pal, D., and Mitra, A. K. In vitro interaction of the HIV protease inhibitor ritonavir with herbal constituents: changes in P-gp and CYP3A4 activity. Am.J.Ther. 2004;11(4):262-277. PubMed
- Izzo, A. A. and Ernst, E. Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 2009;69(13):1777-1798. PubMed
- Chrubasik-Hausmann S, Vlachojannis J, McLachlan AJ. Understanding drug interactions with St John's wort (Hypericum perforatum L.): impact of hyperforin content. J Pharm Pharmacol. 2018.
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
- Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed
- Gümüs KS, Teegelbekkers A, Sauter M, et al. Effect of Tacrolimus Formulation (Prolonged-Release vs Immediate-Release) on Its Susceptibility to Drug-Drug Interactions with St. John's Wort. Clin Pharmacol Drug Dev 2024. PubMed
SEROTONERGIC DRUGS
2 of 6Amitriptyline also falls under SEROTONERGIC DRUGS.
Concomitant use of serotonergic drugs with St. John's wort can lead to increased adverse effects and increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstriction disorders.
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.
Here's the thing to know if you take amitriptyline (Elavil) and are thinking about St. John's wort. Both of these can raise serotonin, one of those brain chemicals that affects mood. When you stack two things that push serotonin in the same direction, you can get too much of a good thing. This is mostly a theoretical concern based on how the two work, not strong human data, so I don't want you to panic.
Still, it's worth watching for signs like agitation, a racing heart, sweating, shakiness, or confusion, which can point to serotonin syndrome. Please don't start or stop either one on your own. Loop in your pharmacist or doctor first so they can look at your full medication list and keep you safe.
- Miller LG. Herbal Medicinals: Selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med 1998;158:2200-11.
- Gordon JB. SSRIs and St. John's Wort: possible toxicity? Am Fam Physician 1998;57:950, 953.
- Beckman SE, Sommi RW, Switzer J. Consumer use of St. John's wort: A survey of effectiveness, safety, and tolerability. Pharmacotherapy 2000;20:568-74.
- Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3. PubMed
- Sarris J, Ravindran A, Yatham LN, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety T
PHOTOSENSITIZING DRUGS
3 of 6Amitriptyline also falls under PHOTOSENSITIZING DRUGS.
St. John's wort might increase photosensitivity reactions due to its hypericin content. However, some clinical research shows that very high doses of St. John's wort are needed to produce phototoxicity in humans.
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.
Here's the thing to know if you're taking amitriptyline (Elavil) and thinking about St. John's wort: this particular concern is about your skin, not about how your body breaks down the medicine. St. John's wort contains a compound called hypericin that can make your skin more sensitive to sunlight, and amitriptyline can do the same thing. Put them together and you might sunburn more easily or get a rash on sun-exposed skin.
I'll be honest with you though, this is a theoretical worry based on how these substances behave, and studies suggest it usually takes very high doses of St. John's wort to actually cause skin problems. Even so, keep in mind that mixing St. John's wort with an antidepressant like amitriptyline raises separate concerns about too much serotonin, so please run this combination by your pharmacist or doctor first.
- Miller LG. Herbal Medicinals: Selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med 1998;158:2200-11.
- Peirce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York, NY: William Morrow and Co., 1999.
- Schempp CM, Muller K, Winghofer B, et al. Single-dose and steady-state administration of Hypericum perfotatum extract (St. John's wort) does not influence skin sensitivity to UV radiation, visible light, and solar-stimulated radiation. Arch Dermatol 2001;
- Bernd A, Ramirez-Bosca A, Kippenberger S, and et al. Phototoxic effects of Hypericum extract in cultures of human keratinocytes compared with those of psoralen. Photochem Photobiol 1999;2(69):218-221.
- Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed
CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES
4 of 6Amitriptyline also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.
Preliminary clinical research in healthy males shows that taking St. John's wort for 14 days induces CYP2C19 and increases metabolism of mephenytoin (Mesantoin). In patients with wild-type 2C19 (2C19*1/*1) metabolism was almost 4-fold greater in subjects who received St. John's wort compared to placebo. In contrast, patients with 2C19*2/*2 and *2/*3 genotypes did not demonstrate a similar increase in metabolism. Theoretically, St. John's wort might increase metabolism of other CYP2C19 substrates.
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.
Here's the gist: St. John's wort can rev up a liver enzyme called CYP2C19, which is one of the pathways that helps clear amitriptyline (Elavil) from your body. When that enzyme speeds up, your amitriptyline levels can drift lower, and that may mean it doesn't control your depression as well as it should.
There's an added wrinkle worth mentioning. Both St. John's wort and amitriptyline nudge serotonin upward, so combining them also raises the risk of too much serotonin (think agitation, sweating, fast heart rate, shakiness). The metabolism evidence here is only moderate and varies a lot person to person, but given two real concerns pulling in different directions, please loop in your pharmacist or doctor before mixing these rather than adjusting anything on your own.
- Wang LS, Zhu B, Abd El-Aty A, et al. The influence of St. John's wort on CYP2C19 activity with respect to genotype. J Clin Pharmacol 2004;44:577-81. PubMed
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
5 of 6Amitriptyline also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
Clinical and in vitro research shows that St. John's wort induces CYP1A2, but to a lesser extent than CYP3A4.
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.
Here's the gist for amitriptyline (Elavil). St. John's wort speeds up a liver enzyme called CYP1A2, which is one of the pathways that helps clear amitriptyline from your body. When that enzyme works faster, more of your amitriptyline can get broken down, so blood levels may drift lower than expected. Amitriptyline is an active drug, not a prodrug, so lower levels usually mean less benefit, like your mood symptoms creeping back, more trouble sleeping, or pain control slipping if that's why you take it.
This effect is considered possible rather than guaranteed, and St. John's wort nudges CYP1A2 less than some other enzymes. Still, since both treat mood, please don't combine or change anything on your own. Loop in your pharmacist or doctor first.
- Henderson L, Yue QY, Bergquist C, et al. St John's wort (Hypericum perforatum): drug interactions and clinical outcomes. Br J Clin Pharmacol 2002;54:349-56..
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
- Van Strater, A. C. and Bogers, J. P. Interaction of St John's wort (Hypericum perforatum) with clozapine. Int.Clin.Psychopharmacol. 2012;27(2):121-124. PubMed
- Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
6 of 6Amitriptyline also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
There is contradictory research about the effect of St. John's wort on CYP2C9. Some in vitro research shows that St. John's wort induces CYP2C9, but to a lesser extent than CYP3A4. St. John's wort also induces metabolism of the S-warfarin isomer, which is a CYP2C9 substrate. Other research shows that St. John's wort 300 mg three times daily for 21 days does not significantly affect the pharmacokinetics of a single 400 mg dose of ibuprofen, which is also a CYP2C9 substrate. Until more is known, use St. John's wort cautiously in patients who are taking CYP2C9 substrates.
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.
Here's the thing worth knowing if you take amitriptyline (Elavil) and are thinking about St. John's wort. Your body partly clears amitriptyline through a liver enzyme called CYP2C9, and St. John's wort can speed that enzyme up. When the enzyme works faster, your medicine may get broken down quicker, which can lower its levels in your blood. The practical worry is that your amitriptyline could become less effective, so your depression symptoms might creep back.
I'll be straight with you though, the evidence here is mixed. Some lab studies show St. John's wort revs up this enzyme, while others show little real change, and amitriptyline isn't a prodrug, so this isn't about boosting its effect. There's also a separate concern: both raise serotonin, so combining them can be risky. Please loop in your pharmacist or doctor before mixing the two.
- Henderson L, Yue QY, Bergquist C, et al. St John's wort (Hypericum perforatum): drug interactions and clinical outcomes. Br J Clin Pharmacol 2002;54:349-56..
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
- Komoroski BJ, Zhang S, Cai H, et al. Induction and inhibition of cytochromes P450 by the St. John's wort constituent hyperforin in human hepatocyte cultures. Drug Metab Dispos 2004;32:512-8. PubMed
- Jiang X, Williams KM, Liauw WS, et al. Effect of St John's wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2004;57:592-9. PubMed
- Bell EC, Ravis WR, Lloyd KB, Stokes TJ. Effects of St. John's wort supplementation on ibuprofen pharmacokinetics. Ann Pharmacother 2007;41:229-34. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
St. John's Wort Also Interacts With Other Medications
St. John's Wort has 754 major, 388 moderate known drug interactions in our database — the Amitriptyline one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against St. John's Wort
We haven’t checked that one against St. John's Wort yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against St. John's Wort. Pick one to open its full report.
Questions About St. John's Wort or Amitriptyline
These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers St. John's Wort or Amitriptyline, 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:
- Is St. John's Wort Safe To Take With Diovan (Valsartan)? ›
- Can Ambien Cause Urine Discoloration? ›
- How Can You Switch From Zoloft To St. John's Wort? ›
- Is Eleuthero Safe With Psychiatric Medications? ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Amitriptyline
This page covers St. John's Wort only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline page lists 296 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).
By severity: 17 major · 228 moderate · 51 minor.
From our pharmacist’s overview on the Amitriptyline page
“Amitriptyline (Elavil), an older antidepressant now often prescribed for nerve pain, migraines, and sleep, is one of the drugs I genuinely want patients to be careful with, and 17 of the 296 supplement and herbal ingredients on this list carry a major rating. Most of the serious ones deepen the drowsiness amitriptyline already causes,…”
Reviewed by 2 · Jul 18, 2026
Taking St. John's Wort as Part of a Dietary Supplement Product? Check It for Interactions
We hold 1,159 real supplement products containing St. John's Wort, each one broken down to its full ingredient list — and combination products often carry several ingredients besides St. John's Wort. Your product may carry other ingredients that interact with Amitriptyline too, on top of St. John's Wort — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where St. John's Wort and Amitriptyline 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.
#156 of 1,452 supplements looked up here in the last 7 days
#54 of 2,830 medications looked up here in the last 7 days
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.
About St. John's Wort
What is St. John's Wort?
- Mild to moderate depression
- Anxiety and stress
- Sleep problems
- Menopausal symptoms
- Wound healing (topical)
St. John's wort is a well-studied herb most often used for mild to moderate depression, and some research suggests it may help with this. However, it has many serious interactions with prescription medicines and is not safe for everyone, so always talk to your pharmacist or doctor before taking it.
About Amitriptyline
What Is Amitriptyline Used For?
Brand name: Elavil
Amitriptyline HCL and Amitriptyline Hydrochloride tablets are used to relieve symptoms of depression. Depression that originates from within the body (called endogenous depression) tends to respond better than other types of depression.
Other Drugs & St. John's Wort
Browse every other medication we’ve checked against St. John's Wort — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
754 interactions
- Diltiazem ›
- Nifedipine ›
- Hydrocortisone ›
- Pancrelipase (prescription Drug) ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Doxorubicin ›
- Fluticasone ›
- Miconazole ›
- Morphine Sulfate ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Ivermectin ›
- Medroxyprogesterone ›
- Medroxyprogesterone Acetate ›
- Rifampin ›
- Testosterone Undecanoate ›
- Aripiprazole ›
- Betamethasone ›
- Caffeine (otc Drug) ›
- Ciclesonide ›
- Cimetidine ›
- Clonazepam ›
- Cyclobenzaprine ›
- Dapsone ›
- Digoxin ›
- Doxycycline Hyclate ›
- Erythromycin Ethylsuccinate ›
Showing 60 of 754 major interactions — see all 754 on the St. John's Wort page.
388 interactions
- Diclofenac Sodium ›
- Theophylline ›
- Ibuprofen ›
- Diphenhydramine ›
- Methylphenidate ›
- Naproxen ›
- Propranolol ›
- Hydrochlorothiazide ›
- Glyburide ›
- Bupropion ›
- Ciprofloxacin ›
- Flurbiprofen ›
- Isotretinoin ›
- Orphenadrine ›
- Diclofenac Potassium ›
- Formoterol ›
- Indomethacin ›
- Phenylephrine ›
- Procainamide ›
- Tazarotene ›
- Trimipramine ›
- Acetaminophen ›
- Etodolac ›
- Griseofulvin ›
- Ketoprofen ›
- Lofepramine ›
- Meloxicam ›
- Nortriptyline ›
- Ofloxacin ›
- Selegiline ›
- Sumatriptan Succinate ›
- Topiramate ›
- Tretinoin ›
- Trichlormethiazide ›
- Azithromycin ›
- Bendamustine ›
- Bendroflumethiazide ›
- Desipramine ›
- Doxepin ›
- Duloxetine ›
- Fluphenazine ›
- Interferon Alfa-2b ›
- Interferon Beta-1b ›
- Levofloxacin ›
- Lisinopril ›
- Metoclopramide ›
- Metolazone ›
- Paroxetine ›
- Riluzole ›
- Sulfasalazine ›
- Valproic Acid ›
- Vortioxetine ›
- Acetazolamide ›
- Aminolevulinic Acid Hydrochloride ›
- Asenapine ›
- Brompheniramine ›
- Captopril ›
- Carisoprodol ›
- Carvedilol ›
- Celecoxib ›
Showing 60 of 388 moderate interactions — see all 388 on the St. John's Wort page.
No interaction 1,687 drugs checked — show the list
We also checked St. John's Wort against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Metoprolol ›
- Aspirin ›
- Valacyclovir ›
- Docusate ›
- Hydroxyurea ›
- Semaglutide ›
- Tirzepatide ›
- Metformin ›
- Amoxicillin ›
- Acyclovir ›
- Lamotrigine ›
- Methotrexate ›
- Pregabalin ›
- Gabapentin ›
- Amphetamine ›
- Bisoprolol ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Cephalexin ›
- Roxithromycin ›
- Pegunigalsidase Alfa-iwxj ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Levetiracetam ›
- Mitomycin ›
- Minoxidil ›
- Factor 7a ›
- Cefaclor ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Ezetimibe ›
- Levodopa ›
- Vancomycin ›
- Spironolactone ›
- Dirithromycin ›
- Lenvatinib ›
- Hethylphenidate Hcl ›
- Azelaic Acid ›
- Bentoquatam ›
- Tenecteplase ›
- Amoxicillin, Clavulanate Potassium ›
- Hydroxychloroquine ›
- Codeine Sulfate ›
- Triptorelin ›
- Dextrothyroxine ›
- Lomustine ›
- Acetylsalicylic Acid ›
- Succimer ›
- Pentobarbitone ›
- Flecainide ›
- Tocainide ›
- Codeine Phosphate ›
- Rocuronium ›
- Halothane ›
- Lorazepam ›
Showing the 60 most looked-up of 1,687 medications checked with no known interaction — see the full St. John's Wort list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Amitriptyline Is Linked to Lower Levels of 3 Nutrients
Natural Medicines records Amitriptyline as a medicine that can lower these. This is not an interaction with St. John's Wort — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Amitriptyline nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking St. John's Wort and Amitriptyline Together: Common Questions
Can you take St. John's Wort with Amitriptyline?
Why are there 6 interactions listed for St. John's Wort and Amitriptyline?
How serious is the St. John's Wort and Amitriptyline interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Amitriptyline and St. John's Wort?
Our pharmacists answer your medication & supplement questions — free.
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.