Drug interactions
Same + Tranylcypromine
Severity: Major
Same and Tranylcypromine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
S-adenosylmethionine (SAMe) has serotonergic activity, and combining it with an MAOI can lead to serotonin syndrome with agitation, hyperthermia, tremor, clonus and autonomic instability. The risk is highest with irreversible nonselective inhibitors such as tranylcypromine.
What this interaction means in plain words
Same and Tranylcypromine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive serotonergic effects, with MAO inhibition preventing the breakdown of serotonin.
What to do
Avoid concurrent use of SAMe with tranylcypromine. If switching, stop SAMe before starting the MAOI and monitor for serotonin toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Tranylcypromine
- 5-HTP + Tranylcypromine Contraindicated
- Amitriptyline + Tranylcypromine Contraindicated
- Amoxapine + Tranylcypromine Contraindicated
- Atomoxetine + Tranylcypromine Contraindicated
- Benzphetamine + Tranylcypromine Contraindicated
- Brimonidine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Same with Tranylcypromine?
MediHelp rates the interaction as major. Same and Tranylcypromine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. S-adenosylmethionine (SAMe) has serotonergic activity, and combining it with an MAOI can lead to serotonin syndrome with agitation, hyperthermia, tremor, clonus and autonomic instability. The risk is highest with irreversible nonselective inhibitors such as tranylcypromine.
How serious is the interaction between Same and Tranylcypromine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use of SAMe with tranylcypromine. If switching, stop SAMe before starting the MAOI and monitor for serotonin toxicity.
What other medicines interact with Tranylcypromine?
MediHelp also lists interactions of Tranylcypromine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Tranylcypromine page.
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