SAM-e (SAMe)

SAM-e (also known as SAMe) is a man-made version of a chemical that occurs naturally in the body.

SAMe is likely effective in alternative medicine for helping treat 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 known if SAMe is effective for treating any medical condition. The FDA has not approved this product for medicinal use. SAMe should not be used instead of medication prescribed by your doctor.

SAMe is often sold as an herbal supplement. There are no regulated manufacturing standards for many herbal products, and some supplements that are sold have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be bought from a trustworthy source to reduce the risk of contamination.

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

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

If you decide to use SAMe, follow the instructions on the package or those given by your doctor, pharmacist, or other healthcare provider. Do not use 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.

Call your doctor if your symptoms do not improve or if they worsen.

If you need surgery, stop taking SAMe at least 2 weeks before the procedure.

Store at room temperature, away from moisture and heat.

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

Do not use SAMe if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. 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 if you 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 if 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 SAM-e 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, just skip it and take your next dose at the usual 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 talking to your doctor if you are using any of the following medications:

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

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