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Herbs & Supplements

AldoMet
Scientific Name: S-adenosyl methionine (SAM-e)
Other Names: Ademetionine, S-adenosyl-L-methionine, SAM, Sammy

What interactions should I watch for?

Prescription Drugs

If SAM-e is taken with prescription antidepressants that belong to the classes known as selective serotonin re-uptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs), serotonin levels may become excessive. Serotonin syndrome is possible.

SSRIs include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
TCAs include amitriptyline, amoxapine, doxepin, and nortriptyline

The risk of side effects from a third type of prescription antidepressants known as monoamine oxidase inhibitors (MAOIs) may be increased if SAM-e is taken at the same time. MAOI therapy should be stopped a minimum of 2 weeks before SAM-e starts. MAOIs include Marplan, Nardil, and tranylcypromine (Parnate). Potential side effects may be:

Aggressive behavior
Coma
Confusion
High blood pressure
High body temperature

Selegiline (Eldepryl) and rasagiline (Azilect), drugs which are related to the MAOI antidepressants and which are used to treat Parkinson's disease, also should not be taken with supplemental SAM-e.

Certain other drugs, such as meperidine and tramadol (Ultram) that are usually given to reduce pain may also raise serotonin levels in the body. If one of these pain-fighting drugs is used at the same time as supplemental SAM-e, the risk of serotonin syndrome may increase.

Non-prescription Drugs

Dextromethorphan (DM) is an anti-coughing ingredient in many non-prescription cough and cold products such as Nyquil and Robitussin DM. Because it may have an increasing effect on serotonin levels, taking dextromethorphan with supplemental SAM-e may result in a higher risk of side effects.

Herbal Products

Potentially, if SAM-e is taken with St John's wort, which also may increase serotonin levels, the risk of serotonin syndrome may also increase.

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals. For specific information on how SAM-e interacts with drugs, other herbals, and foods and the severity of those interactions, please use our Drug Interactions Checker to check for possible interactions.

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Should I take it? >>

Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.

In general, herbal products are not subject to review or approval by the U.S. Food and Drug Administration (FDA). They are not required to be standardized, meaning that the amounts of active ingredients or contaminants they contain may vary between brands or between different batches of the same brand. Not all of the risks, side effects, or interactions associated with the use of herbal products are known because few reliable studies of their use in humans have been done.

This information is provided for your education only. Please share this information with your healthcare provider and be sure that you talk to your doctor and pharmacist about all the prescription and non-prescription medicines you take before you begin to use any herbal product.

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References