S-adenosylmethionine (SAMe)

S-adenosylmethionine (also known as SAMe) is a synthetic version of a chemical that is found naturally in the body.

SAMe is likely helpful in alternative medicine for treating osteoarthritis.

SAMe has been used in alternative medicine as a possibly effective aid for itching, tiredness, and abnormal lab tests in people with liver disease, and for improving symptoms in people with depression.

Other uses that have not been proven by research include treating alcohol-related liver disease, schizophrenia, aging, Alzheimer disease, fibromyalgia, chronic back pain, migraine headaches, seizures, premenstrual syndrome, and chronic fatigue syndrome.

It is not certain if SAMe is effective for treating any medical condition. The FDA has not approved the medicinal use of this product. SAMe should not be used instead of medication prescribed by your doctor.

SAMe is often sold as an herbal supplement. Many herbal compounds do not have regulated manufacturing standards, and some supplements on the market have been found to be contaminated with toxic metals or other drugs. To reduce the risk of contamination, herbal/health supplements should be bought from a trustworthy source.

SAMe may also be used for purposes not listed in this product guide.

When thinking about using SAMe, talk to your doctor. You might also want to consult a practitioner who knows about herbal or health supplements.

If you decide to use SAMe, follow the directions on the package or those given by your doctor, pharmacist, or other healthcare provider. Do not take more of this product than what is recommended on the label.

SAMe should be taken on an empty stomach, at least 30 to 60 minutes before a meal or two hours after a meal.

Contact your doctor if your symptoms do not get better, or if they worsen.

If you are going to have surgery, stop taking SAMe at least 2 weeks beforehand.

Keep it stored at room temperature, away from moisture and heat.

You should not use SAMe if you have bipolar depression, anxiety disorder, or are taking medicine for depression.

Do not use SAMe if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could happen. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

You should not use SAMe if you have bipolar disorder (manic depression), anxiety disorder, or take antidepressant medications.

Do not use SAMe if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could happen. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Tell your doctor if you also use stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with SAMe could lead to a serious condition called serotonin syndrome.

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have:

• a planned surgery;
• Lesch-Nyhan syndrome; or
• Parkinson's disease.

It is not known whether SAMe will harm an unborn baby. Do not use this product without medical advice if you are pregnant.

SAMe is considered likely unsafe to use if you are nursing a baby. Do not use this product without medical advice if you are breastfeeding a baby.

Do not give any herbal/health supplement to a child without medical advice.

Get emergency medical help if you have signs of an allergic reaction: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Although not all side effects are known, SAMe is thought to be likely safe for most adults when used as directed.

Common side effects of s-adenosylmethionine may include:

• changes in hair color;
• headache, dizziness;
• feeling anxious or nervous;
• loss of appetite, vomiting, nausea, upset stomach;
• dry mouth;
• diarrhea, constipation;
• increased sweating; or
• sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

If you miss a dose, skip it and take your next dose at the regular time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Follow your healthcare provider's instructions about any restrictions on food, beverages, or activity.

Do not take SAMe without consulting your doctor if you are using any of the following medications:

• dextromethorphan (a cough medicine like Robitussin DM);
• drugs that impact serotonin, such as antidepressants, stimulants, or migraine medications;
• levodopa; or
• a narcotic medicine like meperidine (Demerol), pentazocine, or tramadol (Ultram, Ultracet).

This list is not complete. Other medications may interact with SAMe, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are included here.