Same (Herb/Suppl)

Brand and Other Names:ademetionine, adenosylmethionine, more...Adomet, Gumbaral, Heptral, Sadenosyl Lmethionine, sammy, Samyr
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Suggested Dosing

Depression

Oral: 400-1600 mg PO qDay

IM/IV: 200-400 mg/day

Osteoarthritis

Oral: 200 mg PO TID

IV: 400 mg/day IV

Liver Disease, Alcohol Related

Oral: 1200-1600 mg PO qDay; no more than 24 months

IV: 200-2000 mg/day IV x 15-30 days

IM: 200 mg/day IM x 30 days

Intrahepatic Cholestasis

Oral: 800 mg PO BID

Fibromyalgia

800 mg PO qDay

AIDS-related Myelopathy (Orphan)

800 mg/day IV x 14 days

Orphan indication sponsor

  • Genopia USA, Inc; 90 Gold Street, 6N; New York, NY 10038
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Suggested Uses

AIDS-related myelopathy, Alzheimer's disease, bursitis/tendinitis, depression, fibromyalgia, heart disease, intrahepatic cholestasis, liver disease, migraine headache, osteoarthritis

Efficacy

Several studies showed comparable effectiveness to TCAs

Standardization of product not as good in US as in Europe

Oral form has poor bioavailability; pos. studies used parenteral SAMe

Mult clinical trials showed comparable effectiveness to NSAIDS, with fewer side effects

Studies showed possibly effective for the treatment of AIDS-related myelopathy, fibromyalgia,& intrahepatic cholestasis

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Interactions

Interaction Checker

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (7)

              • desvenlafaxine

                SAMe and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

              • isocarboxazid

                isocarboxazid and SAMe both increase serotonin levels. Avoid or Use Alternate Drug.

              • linezolid

                linezolid and SAMe both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              • methylene blue

                methylene blue and SAMe both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.

              • phenelzine

                phenelzine and SAMe both increase serotonin levels. Avoid or Use Alternate Drug.

              • procarbazine

                procarbazine and SAMe both increase serotonin levels. Avoid or Use Alternate Drug.

              • tranylcypromine

                tranylcypromine and SAMe both increase serotonin levels. Avoid or Use Alternate Drug.

              Monitor Closely (54)

              • 5-HTP

                5-HTP and SAMe both increase serotonin levels. Use Caution/Monitor.

              • almotriptan

                almotriptan and SAMe both increase serotonin levels. Use Caution/Monitor.

              • amitriptyline

                amitriptyline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • amoxapine

                amoxapine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • buspirone

                buspirone and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • citalopram

                citalopram and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • clomipramine

                clomipramine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • cocaine

                cocaine and SAMe both increase serotonin levels. Use Caution/Monitor.

              • desipramine

                desipramine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • dexfenfluramine

                dexfenfluramine and SAMe both increase serotonin levels. Use Caution/Monitor.

              • dextroamphetamine

                dextroamphetamine and SAMe both increase serotonin levels. Use Caution/Monitor.

              • dextromethorphan

                dextromethorphan and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • dihydroergotamine

                dihydroergotamine and SAMe both increase serotonin levels. Use Caution/Monitor.

              • dihydroergotamine intranasal

                dihydroergotamine intranasal and SAMe both increase serotonin levels. Use Caution/Monitor.

              • doxepin

                doxepin and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • duloxetine

                duloxetine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • eletriptan

                eletriptan and SAMe both increase serotonin levels. Use Caution/Monitor.

              • ergotamine

                ergotamine and SAMe both increase serotonin levels. Use Caution/Monitor.

              • escitalopram

                escitalopram and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • fenfluramine

                fenfluramine and SAMe both increase serotonin levels. Use Caution/Monitor.

              • fluoxetine

                fluoxetine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • fluvoxamine

                fluvoxamine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • frovatriptan

                frovatriptan and SAMe both increase serotonin levels. Use Caution/Monitor.

              • imipramine

                imipramine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • isoniazid

                isoniazid and SAMe both increase serotonin levels. Use Caution/Monitor.

              • L-tryptophan

                L-tryptophan and SAMe both increase serotonin levels. Use Caution/Monitor.

              • levomilnacipran

                levomilnacipran and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • lithium

                lithium and SAMe both increase serotonin levels. Use Caution/Monitor.

              • lofepramine

                lofepramine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • lsd

                lsd and SAMe both increase serotonin levels. Use Caution/Monitor.

              • maprotiline

                maprotiline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • meperidine

                meperidine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • milnacipran

                milnacipran and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • mirtazapine

                mirtazapine and SAMe both increase serotonin levels. Use Caution/Monitor.

              • morphine

                morphine and SAMe both increase serotonin levels. Use Caution/Monitor.

              • naratriptan

                naratriptan and SAMe both increase serotonin levels. Use Caution/Monitor.

              • nefazodone

                nefazodone and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • nortriptyline

                nortriptyline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • paroxetine

                paroxetine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • pentazocine

                pentazocine and SAMe both increase serotonin levels. Use Caution/Monitor.

              • protriptyline

                protriptyline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • rasagiline

                rasagiline and SAMe both increase serotonin levels. Use Caution/Monitor.

              • rizatriptan

                rizatriptan and SAMe both increase serotonin levels. Use Caution/Monitor.

              • selegiline

                selegiline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely. Routine addition of SAM-e to other conventional antidepressant medications, especially MAOIs is not recommended.

              • selegiline transdermal

                selegiline transdermal and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • sertraline

                sertraline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • St John's Wort

                SAMe and St John's Wort both increase serotonin levels. Modify Therapy/Monitor Closely.

              • sumatriptan

                sumatriptan and SAMe both increase serotonin levels. Use Caution/Monitor.

              • sumatriptan intranasal

                sumatriptan intranasal and SAMe both increase serotonin levels. Use Caution/Monitor.

              • tramadol

                SAMe and tramadol both increase serotonin levels. Use Caution/Monitor.

              • trazodone

                trazodone and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • trimipramine

                trimipramine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • venlafaxine

                venlafaxine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

              • zolmitriptan

                zolmitriptan and SAMe both increase serotonin levels. Use Caution/Monitor.

              Minor (0)

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                Adverse Effects

                Frequency Not Defined

                Anxiety

                Diarrhea

                Flatulence

                Headache

                Hypomania/mania

                Nausea/vomiting

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                Warnings

                Contraindications

                MAO inhibitor use within 14 day

                Cautions

                Bipolar disorder

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                Pregnancy & Lactation

                Pregnancy Category: N/A

                Lactation: N/A

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Metabolism: N/A

                Excretion: N/A

                Mechanism of Action

                Methyl donor in many metabolic reactions

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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.