Supplements and Moclobemide.
Moclobemide, sold under the brand name Manerix, is a monoamine oxidase inhibitor (MAOI): it irreversibly inhibits MAO-A and MAO-B, with strict dietary and drug interaction rules.
Moclobemide is a monoamine oxidase inhibitor (MAOI). The class irreversibly inhibits MAO-A and MAO-B, raising synaptic monoamine levels. Current UK use is uncommon. It is confined to depression that has resisted other treatments and is managed in specialist psychiatry, because of the strict dietary rules (foods rich in tyramine) and drug interaction rules. The supplement surface is one of the most restrictive in clinical pharmacology. Anything serotonergic stacked on top can drive serotonin syndrome. St John's Wort, 5-HTP, tryptophan, SAMe, rhodiola, and saffron extract are all excluded. Anything sympathomimetic stacks on noradrenergic effect. Caffeine at high doses, yohimbe, bitter orange, ephedra (where available), and even excessive ginseng warrant care. Supplements rich in tyramine and certain protein extracts carry the same hypertensive crisis concern as the dietary tyramine rule. The psychiatric team is the gatekeeper for any new supplement on an MAOI regimen.
Below are the 7 documented pairs we have explicitly assessed against Moclobemide in the Distil database: 6 red and 1 amber. The pairs cluster around 2 mechanisms: Additive serotonergic activity and MAOI pressor (blood-pressure surge). Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 15 June 2026. Each interaction below is assessed against PubMed-indexed evidence.
Additive serotonergic activity
Red Does 5-HTP interact with ?
5-HTP is the precursor your body uses to make serotonin, and moclobemide is an MAOI (the reversible kind) that blocks serotonin breakdown. Combining them can drive serotonin to dangerous levels, a reaction called serotonin syndrome. Do not combine.
Evidence: Supported by human study data.
Red Does L-Tryptophan interact with ?
Tryptophan is the building block your body uses to make serotonin, and moclobemide is an MAOI (the reversible kind) that blocks serotonin breakdown. Combining them can drive serotonin to dangerous levels and has been named as a cause of serotonin syndrome. Do not combine.
Evidence: Supported by human study data.
Red Does Rhodiola Rosea interact with ?
Rhodiola appears to slow the same enzyme (monoamine oxidase) that moclobemide blocks, and adds its own serotonin activity. Stacking the two could push serotonin too high, risking serotonin syndrome. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does SAMe interact with ?
SAM-e has antidepressant, serotonin-raising activity, and moclobemide is an MAOI (the reversible kind) that blocks serotonin breakdown. Stacking the two could push serotonin too high, risking serotonin syndrome. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does Saffron Extract interact with ?
Saffron has its own antidepressant effect that appears to act on serotonin, and moclobemide is an MAOI (the reversible kind) that blocks serotonin breakdown. Stacking the two could push serotonin too high, risking serotonin syndrome. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Red Does St John's Wort interact with ?
St John's Wort raises serotonin in the brain, and moclobemide is an MAOI (the reversible kind) that blocks serotonin breakdown. Combining them risks serotonin syndrome. This is a strict do-not-combine.
Evidence: Supported by human study data.
MAOI pressor (blood-pressure surge)
Amber Does L-Tyrosine interact with ?
Taking L-Tyrosine with moclobemide could still nudge blood pressure up, because tyrosine is the raw material your body turns into adrenaline and noradrenaline and moclobemide is a reversible MAOI that partly slows their breakdown, though it carries much less of the blood-pressure risk seen with the older irreversible MAOIs. Take this combination only with your prescriber's awareness, and not at high tyrosine doses.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
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- the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
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- the evidence-graded compounds worth adding, and the ones worth dropping
It's a paid report: £79, or £49 founder pricing while we earn our first reviews. The interactions check is one section of it, and you can read a real one in full before you decide.
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