Abstract

Background. Herbal remedies based on Rhodiola rosea L. are known for their adaptogenic, antidepressant, and antiinflammatory properties. However, the potential for drug-herb interactions between these plant-based products and conventional medications highlights the need for a systematic review of the safety data regarding the use of Rhodiola rosea. Aim: to conduct a systematic analysis of scientific evidence on the efficacy and safety of Rhodiola rosea L.-based preparations, with a particular focus on the potential for drug interactions with conventional medications. Materials and methods. A systematic review analyzed 22 of the most relevant studies selected from 36 sources published between 2010 and 2024, addressing the efficacy and safety of Rhodiola rosea-based preparations in the context of drugherb interactions. The selection criteria included studies that directly assessed the clinical safety of using Rhodiola rosea L. phytopreparations in combination with conventional medications. Results. Rhodiola rosea is recognized as a potent herbal adaptogen. However, its efficacy in treating patients with depressive disorders, anxiety, and cognitive impairments remains a subject of scientific debate. Nevertheless, Rhodiola roseabased preparations are often noted for their good tolerability, which is a critical factor for long-term use. Particular attention should be given to the potential interactions of Rhodiola rosea with psychotropic drugs, including selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, given the risk of serotonin syndrome. Another important aspect is the pharmacokinetics of these interactions. Studies of isolated salidroside (one of the primary components of the plant) showed no significant interactions with CYP450 enzymes. However, Rhodiola rosea extracts contain a mixture of biologically active substances, complicating precise predictions of their effects and increasing the risk of unwanted interactions. Rhodiola rosea-based preparations may influence the metabolism of other drugs by inhibiting cytochrome P450 enzymes, particularly CYP2C9, CYP2D6, CYP3A4, and the activity of the P-gp transporter. Conclusion. The analysis highlights the importance of further research to fully understand the efficacy and safety of Rhodiola rosea L., especially in the context of combined pharmacotherapy and potential drug-herb interactions