
Common Names
- Golden root
- Rose root
- Hong Jing Tian
- Rose root extract
- Rosenroot
- SHR-5
For Patients & Caregivers
Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.
How It Works
Rhodiola may improve physical and mental performance by reducing fatigue caused by stress, but it may also interact with some prescription medications.
Rhodiola is used in traditional medicine in Eastern Europe and Asia as a stimulant, to improve performance, and to reduce fatigue and depression. Some pilot studies in humans do support these claims, but more studies are needed. Although drug interactions are not well documented, rhodiola may interact through some pathways the body uses to metabolize prescription medications. Therefore, patients should ask their doctor before taking rhodiola supplements.
Purported Uses
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Depression
Limited data in humans suggest that rhodiola may improve anxiety or mild to moderate depression. Further research is needed. -
Fatigue
Preliminary studies suggest that rhodiola can reduce fatigue under stressful conditions. -
Performance
Preliminary studies suggest rhodiola may improve exercise capacity and mental performance.
Do Not Take If
- You are taking antidepressants: Rhodiola may increase the risk of side effects of these drugs. In addition, there was a case of fast and irregular heartbeat in a young woman who took rhodiola along with her antidepressant for 3 days.
- You are taking drugs for high blood pressure: Rhodiola may increase the risk of side effects.
- You are taking CNS stimulant drugs: Rhodiola may increase the risk of side effects.
- You are taking CYP450 3A4 substrate drugs: Lab studies suggest rhodiola may increase the risk of side effects.
- You are taking CYP450 2C9 substrate drugs: Rhodiola may increase the risk of side effects of these drugs, including phenytoin and warfarin.
- You are taking P-gp substrate drugs: Lab studies suggest rhodiola may increase the risk of side effects.
Side Effects
For Healthcare Professionals
Clinical Summary
Rhodiola is a plant used in traditional medicine in Eastern Europe and Asia to enhance physical and mental performance, stimulate the nervous system, and reduce depressive symptoms. Rhodiola rosea extract and its key constituent salidroside have been researched, although data in humans are limited.
In vitro studies indicate that salidroside may have neuroprotective (8) (9) and anticancer effects (10). Animal data suggest benefits with rhodiola on cognitive function, but most studies were determined to have a high risk of bias (24).
In humans, rhodiola supplementation improved physical endurance (1) and mental performance (2) (3), and reduced fatigue (4) (5) and stress (19) (20). Other preliminary data suggest it may improve symptoms of generalized anxiety disorder (GAD) (6) and mild to moderate depression (7). It was also better tolerated and had fewer side effects than sertraline, although it was also less effective (22).
A small study showed that salidroside may have cardioprotective effects in patients with breast cancer receiving epirubicin (11), but more data are needed to confirm this effect.
Mechanism of Action
In vitro studies suggest that salidroside, a key constituent, confers neuroprotective effects via NO pathway inhibition (9), induces antioxidant enzymes thioredoxin, heme oxygenase-1, and peroxiredoxin-I; downregulates proapoptotic Bax protein; and upregulates antiapoptotic Bcl-XL proteins (8). Rhodiola constituents may also have synergistic antioxidant activity (17) and potential antidepressant effects may be due to inhibition of monoamine oxidases A and B (13). In human breast cancer cells, salidroside induced cell-cycle arrest and apoptosis via mechanisms as yet unidentified, but independent of the estrogen receptor (10).
In animal models, rhodiola exhibits dose- and time-dependent Th1 and Th2 cytokine modulation effects (16).
Contraindications
- Patients taking prescription antidepressant medications should use rhodiola with caution as concurrent use was reported to cause tachyarrhythmia (18).
Adverse Reactions
Herb-Drug Interactions
- Cytochrome P450 3A4 substrates: In preclinical studies, rhodiola inhibits CYP3A4 and can affect the intracellular concentration of drugs metabolized by this enzyme (12) (21). Clinical relevance is yet to be determined.
- Cytochrome P450 2C9 substrates: Rhodiola modestly inhibits CYP2C9, and may affect drugs metabolized by this enzyme, particularly those with a narrow therapeutic index such as phenytoin and warfarin (23).
- P-glycoprotein substrates: In preclinical studies, rhodiola was shown to inhibit P-gp activity and can interfere with the metabolism of certain drugs (12) (21). Clinical relevance is yet to be determined.
- Antidepressants: Rhodiola has MAO inhibition activity and may increase the serotonergic side effects (13).
- Antihypertensives: Rhodiola has MAO inhibition activity and may increase the hypotensive side effects (13).
- CNS Stimulants: Rhodiola has MAO inhibition activity and may enhance the hypertensive effect (13).