Supplements and Rasagiline.
Rasagiline, sold under the brand name Azilect, is a selective MAO-B inhibitor used in Parkinson disease.
Rasagiline is a selective MAO-B inhibitor. It is used in Parkinson disease for symptomatic management and a possible effect on disease progression (selegiline, rasagiline, safinamide). MAO-B selectivity means less of the dietary tyramine concern that defines the older MAOIs. But selectivity scales inversely with dose. At higher doses the agents lose some of their B selectivity, and the MAOI class precautions begin to apply. The supplement surface that matters is serotonergic. 5-HTP combined with selegiline or rasagiline carries serotonin syndrome concern in case reports, and is the closest match for an inferred exclusion. St John's Wort and rhodiola are similarly flagged. Sympathomimetic supplements (yohimbe, bitter orange, panax ginseng, caffeine at high doses) carry care given the underlying mechanism. Other Parkinson medicines (levodopa, dopamine agonists) often run alongside an MAO-B inhibitor. Supplement decisions are best routed through the neurology team rather than community pharmacy.
Below are the 9 documented pairs we have explicitly assessed against Rasagiline in the Distil database: 6 severe and 3 caution. The pairs cluster around 3 mechanisms: Additive serotonergic activity, MAOI pressor (blood-pressure surge), and Additive sympathomimetic activity. 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 14 September 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
Severe Does 5-HTP interact with Rasagiline?
Taking 5-HTP with rasagiline (an MAO-B inhibitor used for Parkinson's) can push serotonin to dangerous levels, because there is less MAO available to break it down, so we treat this as a do-not-combine pair. The combination has caused serotonin syndrome in case reports with other MAO inhibitors.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Severe Does L-Tryptophan interact with Rasagiline?
Taking L-tryptophan with rasagiline (an MAO-B inhibitor used for Parkinson's) can push serotonin to dangerous levels, because there is less MAO available to break it down, so we treat this as a do-not-combine pair. The combination has caused serotonin syndrome in case reports with other MAO inhibitors.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Severe Does Rhodiola Rosea interact with Rasagiline?
Rasagiline is an MAO-B inhibitor used for Parkinson's, and rhodiola appears to slow monoamine oxidase too. Stacking them could push serotonin too high, risking serotonin syndrome. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Severe Does SAMe interact with Rasagiline?
Taking SAMe with rasagiline (an MAO-B inhibitor used for Parkinson's) can push serotonin to dangerous levels, because SAMe has its own serotonin-related activity and there is less MAO available to break it down, so we treat this as a do-not-combine pair without specialist sign-off.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Severe Does Saffron Extract interact with Rasagiline?
Rasagiline is an MAO-B inhibitor used for Parkinson's, and saffron has its own antidepressant effect that appears to act on serotonin. Combined, serotonin can rise too high because there is less of the enzyme available to break it down, risking serotonin syndrome. We treat this as a do-not-combine pair without specialist sign-off.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Severe Does St John's Wort interact with Rasagiline?
Taking St John's Wort with rasagiline (an MAO-B inhibitor used for Parkinson's) can push serotonin to dangerous levels, because there is less MAO available to break it down, so we treat this as a do-not-combine pair.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
MAOI pressor (blood-pressure surge)
Caution Does L-Tyrosine interact with Rasagiline?
Taking L-Tyrosine with rasagiline can in theory raise blood pressure, because tyrosine is the raw material the body turns into noradrenaline and adrenaline and rasagiline is an MAO-B inhibitor, though the risk is lower with a selective MAO-B drug than with the older non-selective MAOIs. Raise this with your prescriber and have blood pressure checked rather than starting on your own.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Caution Does Panax Ginseng interact with Rasagiline?
Ginseng has been reported in a few old case reports to clash with the older MAOI phenelzine, and rasagiline is a more selective MAO inhibitor used for Parkinson's, so any concern is weaker than with the older MAOIs, but ginseng has not been studied with rasagiline. Ginseng has mild stimulant effects, and the UK product information for rasagiline still advises against stimulant-type decongestants and cold remedies alongside it. Check with the doctor who prescribes your rasagiline before starting ginseng, and keep to the rasagiline dose they set.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Additive sympathomimetic activity
Caution Does Yohimbe interact with Rasagiline?
Yohimbe raises blood pressure and noradrenaline. Combined with rasagiline (a Parkinson's MAO-B inhibitor), it can push blood pressure unpredictably high. We would not recommend combining without specialist supervision.
Evidence: Limited human data, from small studies or case reports.
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 the checker decides
Every result has a source
Each pair we have assessed is cited to a published study (PMID) or the British National Formulary, so you can read the source yourself.
Four kinds of answer
Severe, caution, no known interaction, and not yet assessed. A pair we have not assessed is never shown as clear.
- Severe
- Caution
- No known interaction
- Not yet assessed
Nothing in our data is not a clearance
When nothing in our data records a problem with a pair, the result says no known interaction at typical doses, which is not a clearance: your pharmacist or GP can check the pair against your full medical history.
A 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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