Rhodiola Side Effects and Medicine Interactions
Reported side effects of Rhodiola rosea, what is and is not documented about antidepressants, losartan and other medicines, and who should ask a clinician first.
Content last updated . This page has not been medically reviewed.
Safety first. Supplements can cause side effects and interact with medicines. Read mushroom safety and interactions before you use any mushroom product.
Serotonin syndrome: know the signs first. MedlinePlus describes serotonin syndrome as a potentially life-threatening reaction to certain medicines that most often occurs when two or more medicines that affect serotonin are taken together. [1] Signs include agitation or restlessness, fast heartbeat and high blood pressure, heavy sweating not due to activity, fever, tremor and overactive reflexes. [1] MedlinePlus says to contact your provider right away if you have these symptoms. [1] Call 911 if symptoms are severe. If you take an antidepressant, MedlinePlus advises: do not stop your medicine, and talk to your provider first. [1] See serotonin syndrome and other medicine reaction signs.
Is rhodiola known to cause it? Proper evidence not found. We searched PubMed for rhodiola with case reports, adverse events, mania and agitation and found no human case report of serotonin syndrome linked to rhodiola. A lab study found that rhodiola root extracts blocked monoamine oxidase enzymes in a test-tube assay. [2] That is a reason to ask your pharmacist, not evidence of harm in people.
Side effects that sources report
Rhodiola rosea L. roots and rhizomes are the part used. [3]- NCCIH (US): possibly safe for up to 12 weeks; side effects may include dizziness, headache, insomnia, and either dry mouth or excessive saliva production. [4]
- EU herbal committee (HMPC, 2024): headache; nausea, abdominal pain and diarrhoea; skin rash and itching, each with frequency not known. [5] Its monograph lists hypersensitivity to the active substance as a reason not to use it. [5]
- In trials: dizziness and dry mouth were the most common problems in a 10-person pilot. [6] In a 12-week depression trial, fewer people on rhodiola reported adverse events (30.0%) than on sertraline (63.2%), with 16.7% on placebo. [7] In a 42-day trial, adverse events did not differ from placebo. [8]
Long-term safety beyond about 12 weeks: Proper evidence not found in the sources we read. [4]
Medicines: what is documented and what is theory
| Medicine group | What the sources found | Type of evidence |
|---|---|---|
| Losartan (blood pressure) | NCCIH says interactions with losartan have been reported. [4] In 13 healthy volunteers, 14 days of a rhodiola product lowered the losartan-to-metabolite ratio by 21%, which the authors read as reduced activity of the liver enzyme CYP2C9. [9] In rabbits, losartan levels almost doubled. [10] | Small human study plus animal and lab data |
| Warfarin, phenytoin and other CYP2C9 medicines | The same authors wrote that the modest effect might be relevant for medicines with a narrow safety margin such as warfarin and phenytoin. [9] We did not find a human warfarin study with rhodiola in the sources we read. | Theoretical |
| Antidepressants (SSRIs, SNRIs, MAOIs) | Only the test-tube enzyme result above. [2] One 12-week trial gave rhodiola capsules with sertraline, but the abstract does not describe side effects of the combination. [11] | Lab data; combination safety: Proper evidence not found |
| Other medicines cleared by liver enzymes | In the 13-volunteer study, tests for four other enzymes showed no significant effects. [9] | Small human study |
| Stimulants, sedatives, diabetes and thyroid medicines | Proper evidence not found in the sources we read. We checked NCCIH, the EU monograph and PubMed searches on rhodiola interactions. | Not described |
These findings conflict in tone: the EU monograph states that no clinically relevant interactions have been observed. [5] Both can be true, because a lab change in an enzyme is not the same as a proven effect on a person taking a medicine. Read how interactions work, then see supplements and antidepressants. Never start or stop a prescribed medicine because of an herb; ask the prescriber or pharmacist.
Pregnancy, breastfeeding and children
NCCIH says little is known about whether rhodiola is safe in pregnancy or breastfeeding. [4] The EU monograph says safety in pregnancy and lactation has not been established and does not recommend use then, and does not recommend use under age 18. [5]Liver, kidney, surgery and quality
- Liver and kidney: Proper evidence not found in the sources we read. We could not read the NIH LiverTox or LactMed entries for rhodiola this session, so we make no statement from them.
- Before surgery: a 2024 review reports that US anesthesiology groups recommend stopping herbal medications 1-2 weeks before elective surgery, and that 50-70% of surgical patients do not tell their physicians about herbal use. [12] Rhodiola is not named in the abstract. Tell the surgical team about every supplement; see surgery and procedures.
- Quality: a UK study used DNA barcoding on 14 "roseroot" products. Of 13 that gave readable DNA, 3 matched only other plants (alfalfa and fenugreek), and in the other 10 only five matched Rhodiola rosea. The authors concluded that substitution or mixing is common in these supplements, while cautioning that degraded DNA is not proof of a bad product. [13] NCCIH notes supplements are not FDA-approved before sale. [4] See quality testing and certifications.
- Depression: NCCIH advises anyone who may have depression to consult a health care provider. [4] In the US, call 988 for crisis support.
What trials found for fatigue, stress and mood is on this page, and the plant profile is at rhodiola.
Frequently asked questions
Can I take rhodiola with an SSRI?
Ask your prescriber or pharmacist first. We found no human report of serotonin syndrome with rhodiola, but the combination has not been shown safe either: a trial gave rhodiola with sertraline and the abstract did not describe safety. [11] Medicines that raise serotonin can cause serotonin syndrome together. [1]
Does rhodiola interact with blood pressure medicine?
NCCIH reports interactions with losartan. [4] A small human study found reduced CYP2C9 activity, [9] though the EU monograph says no clinically relevant interactions have been observed. [5] Ask a pharmacist.
What are the most common side effects?
NCCIH lists dizziness, headache, insomnia, and dry mouth or excessive saliva. [4] The EU monograph adds nausea, abdominal pain, diarrhoea, rash and itching. [5]
Is rhodiola safe in pregnancy?
Safety has not been established, and the EU herbal committee does not recommend it in pregnancy or breastfeeding. [5]
Is rhodiola an MAOI?
In a lab assay, rhodiola root extracts inhibited monoamine oxidase enzymes. [2] Whether this matters in people taking rhodiola supplements is Proper evidence not found; none of the sources we read describe it as acting like an MAOI medicine in people.
References
- MedlinePlus (US National Library of Medicine). Serotonin syndrome. Read 2026-10-23.
- van Diermen D, Marston A, Bravo J, et al. Monoamine oxidase inhibition by Rhodiola rosea L. roots. J Ethnopharmacol. 2009. PubMed 19168123. Read 2026-10-23.
- European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). Rhodiolae roseae rhizoma et radix - herbal medicinal product (public summary page). Read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH). Rhodiola: Usefulness and Safety. Read 2026-10-23.
- European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). European Union herbal monograph on Rhodiola rosea L., rhizoma et radix, Final - Revision 1. EMA/HMPC/24177/2023, 20 March 2024. Read 2026-10-23.
- Bystritsky A, Kerwin L, Feusner JD. A pilot study of Rhodiola rosea (Rhodax) for generalized anxiety disorder (GAD). J Altern Complement Med. 2008. PubMed 18307390. Read 2026-10-23.
- Mao JJ, Xie SX, Zee J, et al. Rhodiola rosea versus sertraline for major depressive disorder: a randomized placebo-controlled trial. Phytomedicine. 2015. PubMed 25837277. Read 2026-10-23.
- Punja S, Shamseer L, Olson K, Vohra S. Rhodiola rosea for mental and physical fatigue in nursing students: a randomized controlled trial. PLoS One. 2014. PubMed 25268730. Read 2026-10-23.
- Thu OK, Spigset O, Hellum B. Effect of commercial Rhodiola rosea on CYP enzyme activity in humans. Eur J Clin Pharmacol. 2016. PubMed 26613955. Read 2026-10-23.
- Spanakis M, Sfakianakis A, Vrentzos G, et al. Pharmacokinetic interaction between losartan and Rhodiola rosea in rabbits. Pharmacology. 2013. PubMed 23327826. Read 2026-10-23.
- Gao L, Wu C, Liao Y, Wang J. Antidepressants effects of Rhodiola capsule combined with sertraline for major depressive disorder: a randomized double-blind placebo-controlled clinical trial. J Affect Disord. 2020. PubMed 32090788. Read 2026-10-23.
- Elvir Lazo OL, et al. Use of herbal medication in the perioperative period: potential adverse drug interactions. J Clin Anesth. 2024. PubMed 38613937. Read 2026-10-23.
- Ruhsam M, Hollingsworth PM. Authentication of Eleutherococcus and Rhodiola herbal supplement products in the United Kingdom. J Pharm Biomed Anal. 2018. PubMed 29154110. Read 2026-10-23.