St Johns Wort and Tramadol

Supplement–drug interaction evidence from the TruthStack database.

SeverityCRITICAL
Evidence TierModerate
Interaction TypeSEROTONERGIC RISK
MechanismPHARMACODYNAMIC
Last Reviewed2026-02-15

Summary

St. John's Wort with tramadol significantly increases serotonin syndrome risk. Tramadol is a serotonin-norepinephrine reuptake inhibitor. SJW also induces CYP3A4 altering tramadol metabolism. Combination is flagged in literature. Discuss with your prescriber or pharmacist.

API Reference

GET https://api.truthstack.co/v1/check?c1=st_johns_wort&c2=tramadol

Open, unauthenticated. Returns JSON. Developer documentation

Related Interactions

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What this page is and is not. TruthStack is an informational reference database that describes published pharmacological findings. It does not provide medical advice, diagnosis, or treatment recommendations. The information on this page reflects flags in our database and should not replace consultation with a qualified healthcare provider. Always discuss supplement-drug combinations with your prescriber or pharmacist.