Tranylcypromine and SAM-e

Desk tier: Avoid together

Mechanism: MAOI × serotonergic (serotonin syndrome / hypertensive crisis)

“Concomitant use of PARNATE or use in rapid succession with the products in Table 1 is contraindicated … s-adenosyl-L-methionine (SAM-e)”

Parnate (tranylcypromine), section 4.1 Combination with Certain Drugs. DailyMed label

Why this grade

Parnate (tranylcypromine) label, Contraindications

The Parnate (tranylcypromine) label lists this combination under Contraindications. 4.1 Combination with Certain Drugs: "Concomitant use of PARNATE or use in rapid succession with the products in Table 1 is contraindicated … s-adenosyl-L-methionine (SAM-e)" Named in the label: "s-adenosyl-L-methionine (SAM-e)" Retrieved from DailyMed 2026-10-19.

Parnate (tranylcypromine) label on DailyMed

FDA boxed / safety communication

MAOI labels contraindicate serotonergic agents. Serotonin toxicity, hypertensive crisis.

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Educational reference only. Not FDA-cleared. The Prescribing Information governs.

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