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 8 documented pairs we have explicitly assessed against Moclobemide in the Distil database: 6 red and 2 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 28 August 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
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, from small studies or case reports, alongside a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Panax Ginseng interact with ?
Ginseng has been reported once to clash with the older MAOI phenelzine, in a short case report whose detail we cannot check at source, so we apply a lighter version of the same caution to moclobemide, which acts on the same enzyme but reversibly. Moclobemide is much less prone to the blood-pressure reactions that make the older MAOIs risky: in a human comparison it took about sixteen times more dietary tyramine to push blood pressure up on moclobemide than on phenelzine. If you take moclobemide, it is still worth checking with the doctor who manages your antidepressant before starting ginseng.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
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.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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