Medication · mao b inhibitor

Supplements and Rasagiline.

Every documented pair, every citation. Below: 2 documented pairs grouped by mechanism.

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 is similarly flagged. Sympathomimetic supplements (yohimbe, bitter orange, 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 2 documented pairs we have explicitly assessed against Rasagiline in the Distil database: 1 red and 1 amber. The pairs cluster around 2 mechanisms: Additive serotonergic activity 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

Additive serotonergic activity

Red 5-HTP

Rasagiline is an MAO-B inhibitor used for Parkinson's. Combined with 5-HTP, serotonin can rise to dangerous levels because there is less MAO available to break it down. We treat this as a do-not-combine pair. The combination has caused serotonin syndrome in case reports with other MAO inhibitors.

BNF: Rasagiline

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Additive sympathomimetic activity

Amber Yohimbe

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.

BNF: Rasagiline

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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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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How we decide

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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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.