SAM-E-TMG (same butanedisulfonate/betaine)

There are 1 contraindications. These drug combinations generally should not be dispensed or administered to the same patient. A manufacturer label warning that indicates the contraindication warrants inclusion of a drug combination in this category, regardless of clinical evidence or lack of clinical evidence to support the contraindication.

Drug Interaction

Drug Names

S-Adenosylmethionine (SAM-e)/Tranylcypromine SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: S-adenosylmethionine (SAMe), and tranylcypromine are suggested to have similar effects on the serotonin pathway, therefore their use together may result in additive or synergistic effects. CLINICAL EFFECTS: Concomitant use of S-adenosylmethionine and antidepressants which inhibit neuronal serotonin reuptake may result in serotonin syndrome. Symptoms of serotonin syndrome may include tremor, agitation, diaphoresis, hyperreflexia, clonus, tachycardia, hyperthermia, and muscle rigidity.(2) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturer of tranylcypromine states that concurrent use of S-adenosylmethionine and tranylcypromine is contraindicated.(1) If concurrent therapy is warranted, patients should be monitored for signs and symptoms of serotonin syndrome. Instruct patients to report muscle twitching, tremors, shivering and stiffness, fever, heavy sweating, heart palpitations, restlessness, confusion, agitation, trouble with coordination, or severe diarrhea. DISCUSSION: There is a case report with a tricyclic antidepressant (clomipramine) and tranylcypromine of serotonin syndrome. Tricyclic antidepressants are also known to increase serotonin levels.(2)

PARNATE, TRANYLCYPROMINE SULFATE

Drug contraindication overview.

No enhanced Contraindications information available for this drug.

Adverse reaction overview.

No enhanced Common Adverse Effects information available for this drug.

No enhanced Pediatric Use information available for this drug.

Contraindicated

None

Severe Precaution

None

Management or Monitoring Precaution

None