Hydrocodone + St. Johns Wort

SAFE — No Known Interaction

🟢 SAFE — St. Johns Wort and Hydrocodone can be taken together safely.

Evidence level: THEORETICAL

What this interaction means

St. Johns Wort and Hydrocodone are safe to take together. No adverse interactions have been reported in medical literature.

How it works (mechanism)

No clinically significant interaction between St. Johns Wort and Hydrocodone has been documented in medical literature or FDA drug labeling.

Practical advice

No interaction between St. Johns Wort and Hydrocodone has been documented. As a best practice, keep a list of everything you take — including St. Johns Wort — and share it with your healthcare provider at every visit. This helps them spot potential issues early.

Timing

Take Hydrocodone exactly as prescribed. St. Johns Wort can be taken with a meal at a different time. Sedating botanicals (valerian, kava, passionflower) can amplify opioid sedation and respiratory depression. Stimulating adaptogens (rhodiola, ginseng) may be safer choices during opioid therapy.

Risk factors

Higher risk for: elderly, opioid-naive patients, those with sleep apnea, respiratory conditions, concurrent CNS depressants (benzodiazepines, alcohol), liver impairment, or history of substance use disorder.

Symptoms to watch for

Monitor for CNS depression and respiratory effects when combining St. Johns Wort with Hydrocodone. Watch for: excessive drowsiness, slowed breathing, confusion, severe constipation, nausea, dizziness, or impaired coordination. Do not drive or operate machinery. When to seek emergency help: Breathing becomes slow or shallow, extreme drowsiness or inability to wake, blue lips or fingernails, severe confusion, or loss of consciousness. Keep naloxone (Narcan) accessible if prescribed opioids. Never mix with alcohol.

What to tell your doctor

No urgent need to discuss, but always keep your doctor informed of your full supplement and medication list. An up-to-date list helps them make the best treatment decisions.

Safer alternatives

Safe combination at standard doses. Continue your medication as prescribed. Inform your doctor or pharmacist that you are using both, so they can monitor for any changes over time.

Frequently asked questions

Can I take Hydrocodone and St. Johns Wort together?

St. Johns Wort and Hydrocodone are safe to take together. No adverse interactions have been reported in medical literature.

When should I take Hydrocodone vs St. Johns Wort?

Take Hydrocodone exactly as prescribed. St. Johns Wort can be taken with a meal at a different time. Sedating botanicals (valerian, kava, passionflower) can amplify opioid sedation and respiratory depression. Stimulating adaptogens (rhodiola, ginseng) may be safer choices during opioid therapy.

What symptoms should I watch for if I combine Hydrocodone and St. Johns Wort?

Monitor for CNS depression and respiratory effects when combining St. Johns Wort with Hydrocodone. Watch for: excessive drowsiness, slowed breathing, confusion, severe constipation, nausea, dizziness, or impaired coordination. Do not drive or operate machinery. When to seek emergency help: Breathing becomes slow or shallow, extreme drowsiness or inability to wake, blue lips or fingernails, severe confusion, or loss of consciousness. Keep naloxone (Narcan) accessible if prescribed opioids. Never mix with alcohol.

Are there safer alternatives to combining Hydrocodone with St. Johns Wort?

Safe combination at standard doses. Continue your medication as prescribed. Inform your doctor or pharmacist that you are using both, so they can monitor for any changes over time.

What should I tell my doctor about taking Hydrocodone and St. Johns Wort?

No urgent need to discuss, but always keep your doctor informed of your full supplement and medication list. An up-to-date list helps them make the best treatment decisions.

Explore more interactions

Or browse the full interaction database (121,000+ pairs).