Same

Are there any interactions with medications?

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Dextromethorphan (Robitussin DM, and others)
Interaction Rating: Major Do not take this combination.

SAMe can affect a brain chemical called serotonin. Dextromethorphan (Robitussin DM, others) can also affect serotonin. Taking SAMe along with dextromethorphan (Robitussin DM, others) might cause too much serotonin in the brain and serious side effects including heart problems, shivering, and anxiety. Do not take SAMe if you are taking dextromethorphan (Robitussin DM, and others).

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Medications for depression (Antidepressant drugs)
Interaction Rating: Major Do not take this combination.

SAMe increases a brain chemical called serotonin. Some medications for depression also increase the brain chemical serotonin. Taking SAMe along with these medications for depression might increase serotonin too much and cause serious side effects including heart problems, shivering, and anxiety. Do not take SAMe if you are taking medications for depression.

Some of these medications for depression include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil), and others.

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Medications for depression (MAOIs)
Interaction Rating: Major Do not take this combination.

SAMe increases a chemical in the brain. This chemical is called serotonin. Some medications used for depression also increase serotonin. Taking SAMe along with these medications used for depression might cause too much serotonin in the body, and serious side effects including heart problems, shivering, and anxiety.

Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.

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Levodopa
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Levodopa is used for Parkinson's disease. SAMe can chemically change levodopa in the body and decrease the effectiveness of levodopa. Taking SAMe along with levodopa might make Parkinson's disease symptoms worse. Do not take SAMe if you are taking levodopa.

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Meperidine (Demerol)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

SAMe increases a chemical in the brain called serotonin. Meperidine (Demerol) can also increase serotonin in the brain. Taking SAMe along with meperidine (Demerol) might cause too much serotonin in the brain and serious side effects including heart problems, shivering, and anxiety.

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Pentazocine (Talwin)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

SAMe increases a brain chemical called serotonin. Pentazocine (Talwin) also increases serotonin. Taking SAMe along with pentazocine (Talwin) might cause serious side effects including heart problems, shivering, and anxiety. Do not take SAMe if you are taking pentazocine (Talwin).

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Tramadol (Ultram)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Tramadol (Ultram) can affect a chemical in the brain called serotonin. SAMe can also affect serotonin. Taking SAMe along with tramadol (Ultram) might cause too much serotonin in the brain and side effects including confusion, shivering, stiff muscles, and other side effects.

Dosing considerations for SAMe.

The following doses have been studied in scientific research:

BY MOUTH:

• For depression: 400-1600 mg per day.
• For osteoarthritis: 200 mg three times daily.
• For fibromyalgia: 800 mg per day.