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S-Adenosyl-Methionine (SAMe)

By Rania Gollakner, BS, DVM, MPH

Medications

What is SAMe?

SAMe or S-adenosyl-methionine (brand names: Denosyl®, Novifit®, Zentonil®, Donamet®, Gumbaral®, Isimet®, MoodlLift®, S Amet®, Samyr®, Transmetil®, Tunik®) is the bioactive form of methionine, an essential amino acid nutrient that is found abundantly in foods, especially in meat and sunflower seeds. SAMe is used in the body for many important functions, such as brain, heart, hormone, antioxidant, detoxifying, and other metabolic functions. It is a commonly used supplement to treat liver disease in pets, especially cats and dogs.

"It is a commonly used supplement to treat liver disease in pets, especially cats and dogs."

SAMe has been used to treat liver disease, osteoarthritis, age-related behavior changes, and other cognitive and nerve disorders in mammals. In humans, it has been used for depression, autism, Alzheimer’s and Parkinson’s disease, peripheral neuropathy, spinal cord degeneration, inflammation, pain, osteoarthritis, sleeping problems, and liver disease.

What is a supplement?

Dietary supplements are substances that can be used to supplement the diet, such as vitamins, minerals, amino acids, herbs, botanicals, enzymes, and probiotics. While many supplements are sold over the counter, they still contain ingredients that have biological effects that should be managed by your veterinarian. Follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

There are differences in how countries regulate supplements. In the United States, these substances are not as vigorously regulated by the FDA as other medications, which means they can be sold without the manufacturer proving their effectiveness, safety, and without a guarantee of consistent or accurately reported ingredients. In Canada, products that have been evaluated for quality, safety, and effectiveness by Health Canada and authorized for sale will have a license number on the label.

 

How effective is SAMe?

Limited studies in animals have been performed, but there is anecdotal evidence that SAMe works to treat liver disease. One study did not find SAMe alone to be an effective treatment for osteoarthritis.

How is SAMe given?

SAMe is given by mouth in the form of a tablet or a compounded liquid. Give on an empty stomach, at least an hour before feeding or two hours after feeding. If vomiting occurs when dosed on an empty stomach, give future doses with a small amount of food. Do not remove the tablets from the blister pack until ready to use. Do not crush or split the tablets.

This medication can take up to a few weeks before full effects are noted, but gradual improvements are usually noticeable after a few days.

What if I miss giving my pet the supplement?

If you miss a dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Side effects are rare, but may include mild nausea and stomach upset. In humans, side effects also include constipation, dry mouth, sleeplessness, headache, sweating, and dizziness. This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this supplement?

Studies are limited for this supplement and therefore information regarding risk factors is also limited. Use cautiously in pets that are pregnant or in nursing mothers as safety has not been established.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with SAMe: antidepressants (SSRIs), dextromethorphan, meperidine, pentazocine, or tramadol.

Vitamins, herbal therapies, and supplements have the potential to interact with each other, as well as with prescription and over the counter medications. It is important to tell your veterinarian about any medications (including all vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this supplement?

Your veterinarian may monitor your pet to be sure that the medication is working by monitoring liver enzymes, bilirubin, and bile acids. Monitor your pet at home for improvements in clinical signs and monitor for side effects.

How do I store SAMe?

Unless otherwise directed on the label, store the tablets at room temperature in a dry place (such as a moisture-resistant container) and protect from heat. Store compounded medications according to the label.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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