Drug & supplement interaction

Same + Rivaroxaban

Rivaroxaban brand name: Xarelto.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Oct 4, 2026
The bottom line No known interaction

We found no known interaction between Same and Rivaroxaban in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Same and Rivaroxaban

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Rivaroxaban and Same in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Same safety at a glance

Same overall Use caution Often well tolerated short-term, but it can cause stomach upset and may trigger mania in people with bipolar disorder.
Pregnancy Possibly Safe When used intravenously short-term during the third trimester of pregnancy. In two small-scale trials, SAMe 800 mg daily was used intravenously for 14-20 days d... Read the full pregnancy detail
Breastfeeding Not established There is not enough reliable information, so caution is advised.

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Rivaroxaban and Same? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Rivaroxaban

Interactions in our licensed database are recorded against drug classes, not just single drug names. Rivaroxaban is filed under 5 classifications — including anticoagulant/antiplatelet drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. Same has documented interactions with 2 drug classes — the most serious being levodopa (moderate) and serotonergic drugs (moderate) — and none of Rivaroxaban’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Same Does Interact With Other Medications

Same has 189 moderate known drug interactions in our database — Rivaroxaban isn’t one of them. If you take anything else, check it against the full list below.

Moderate 189 No known interaction 2,641 (incl. Rivaroxaban)
Taking anything else?

Check Another of Your Medications Against Same

Covers the 2,830 medications we’ve checked against Same. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Same and Rivaroxaban May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Bleeding in the gut Worth acting on reported in 10.5% of FDA reports for Rivaroxaban Additional detail

    Same

    “When taken orally or given intravenously, SAMe may cause increased salivation, bloating, flatulence, nausea, vomiting, diarrhea, stomach ache, heartburn, constipation, hunger, thirst, anorexia, blood in the stool, and dry mouth.”

    Same · Natural Medicines adverse-effect record, reported in anorexia.

    Rivaroxaban

    Listed in the ADVERSE REACTIONS section of the FDA label for Rivaroxaban, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Vomiting Additional detail

    Same

    “Orally, SAMe is generally well tolerated when used in typical doses. Side effects are more common with higher doses.

    Most Common Adverse Effects:

    Orally: Anorexia, constipation, diarrhea, dizziness, dry mouth, flatulence, headache, insomnia, nausea, nervousness, sweating, vomiting.”

    Same · Natural Medicines adverse-effect record, reported in anorexia.

    Rivaroxaban

    Listed in the ADVERSE REACTIONS section of the FDA label for Rivaroxaban. Read the label on DailyMed ›

Reported for Same but not commonly for Rivaroxaban: thoughts of self-harm, low mood, constipation and vivid dreams or nightmares.

Effects for Rivaroxaban come from the ADVERSE REACTIONS section of its FDA label; effects for Same come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 206,938 voluntary FDA FAERS reports for Rivaroxaban that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Same in Pregnancy & Breastfeeding

Pregnancy Possibly Safe

When used intravenously short-term during the third trimester of pregnancy. In two small-scale trials, SAMe 800 mg daily was used intravenously for 14-20 days during the third trimester of pregnancy for cholestasis. No adverse effects were observed. However, use of SAMe in pregnancy should only be considered when benefits clearly outweigh the potential risks. There is insufficient reliable information available about the use of SAMe at higher doses, for extended periods of time, or during the earlier trimesters of pregnancy.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Same or Rivaroxaban

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Same or Rivaroxaban, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Rivaroxaban

This page covers Same only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rivaroxaban page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Rivaroxaban page

“Grapefruit is the interaction I would flag first for anyone taking rivaroxaban (Xarelto). It slows how the body clears this blood thinner, and higher levels mean more bleeding risk.”

Reviewed by 2 · Jul 18, 2026

Open the Rivaroxaban interaction page

One more smart check

Taking Same as Part of a Dietary Supplement Product? Check It for Interactions

We hold 9 real supplement products containing Same, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Same. Even though Same itself has no known interaction with Rivaroxaban, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Same and Rivaroxaban Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Same
Top half

#444 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Rivaroxaban
Top 1%

#26 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Same reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified October 4, 2026. The Same and Rivaroxaban records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Same

What is Same?

Same
  • Depression
  • Osteoarthritis joint pain
  • Liver conditions
  • Fibromyalgia

SAM-e is a compound your body makes naturally that is sold as a supplement, most often for depression and osteoarthritis. Some research suggests it may help with these conditions, but the quality of evidence is mixed and more study is needed. Talk with your pharmacist or doctor before trying it, especially if you take other medicines or have bipolar disorder.

Not a plant; a compound made naturally in the body (supplements are made synthetically) · Enteric-coated tablets, capsules; less commonly injectable (used in some countries under medical supervision)

An interaction check asks whether these two react with each other — it does not ask whether Same is a good idea for someone in your situation. Here is what our Same record says about it on its own.

Same: dosing

There is no single official standardized dose of SAM-e, and the amount studied has varied depending on the condition and the salt form used. SAM-e is often sold as enteric-coated tablets to help it survive stomach acid, and some people take it before meals.Do not assume more is better. Starting low and using the lowest helpful dose may reduce the chance of side effects.

From our Same monograph — the full record covers uses, side effects and every documented interaction.

Read the full Same monograph & all interactions
Medication

About Rivaroxaban

What Is Rivaroxaban Used For?

Brand name: Xarelto

Rivaroxaban helps prevent and treat harmful blood clots. Across products, adults use it to lower stroke risk in nonvalvular atrial fibrillation, treat deep vein thrombosis (DVT) and pulmonary embolism (PE), and lower the chance those clots come back.

Rivaroxaban tablets are also used to prevent DVT after hip or knee replacement surgery and to prevent venous thromboembolism (VTE) in acutely ill medical patients. With aspirin, they reduce major cardiovascular events in coronary artery disease (CAD) and major thrombotic vascular events in peripheral artery disease (PAD). Children use it too: rivaroxaban for oral suspension (and Xarelto and Rivaroxaban tablets) is for VTE treatment and recurrence prevention from birth to under 18 years, and for clot prevention in children 2 and older with congenital heart disease after the Fontan procedure.

Most-Reported Side Effects for Rivaroxaban

From FAERS, the FDA’s public side-effect reporting system (206,938 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Gastrointestinal haemorrhage 21,637 reports
Hemorrhage 7,796 reports
Dyspnea 7,337 reports
Epistaxis 6,774 reports
Fatigue 6,729 reports
See full Rivaroxaban drug information
Keep checking

Other Drugs & Same

Browse every other medication we’ve checked against Same — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
189Moderate
0Minor
2,640No known interaction
189 Moderate 2,640 No interaction
Moderate

189 interactions

Showing 60 of 189 moderate interactions — see all 189 on the Same page.

No interaction 2,640 drugs checked — show the list

We also checked Same against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,640 medications checked with no known interaction — see the full Same list.

See the full Same interactions page
See every supplement checked against Rivaroxaban, ranked by severity
Evidence & sources

Same References

The 31 references that drive our Same monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Perna AF, Castaldo P, Ingrosso D, et al. Homocysteine, a new cardiovascular risk factor, is also a powerful uremic toxin. J Nephrol 1999;12:230-40.
  2. Mato JM, Camara J, Fernandez de Paz J, et al. S-adenosylmethionine in alcoholic liver cirrhosis: a randomized, placebo-controlled, double-blind, multicenter clinical trial. J Hepatol 1999;30:1081-9. PubMed
  3. Iruela LM, Minguez L, Merino J, Monedero G. Toxic interaction of S-adenosylmethionine and clomipramine. Am J Psychiatry 1993;150:522. PubMed
  4. Bradley JD, Flusser D, Katz BP, et al. A randomized, double blind, placebo controlled trial of intravenous loading with S-adenosylmethionine (SAM) followed by oral SAM therapy in patients with knee osteoarthritis. J Rheumatol 1994;21:905-11.
  5. Berlanga C, Ortega-Soto HA, Ontiveros M, Senties H. Efficacy of S-adenosyl-L-methionine in speeding the onset of action of imipramine. Psychiatry Res 1992;44:257-62. PubMed
  6. Kagan BL, Sultzer DL, Rosenlicht N, Gerner RH. Oral S-adenosylmethionine in depression: a randomized, double-blind, placebo-controlled trial. Am J Psychiatry 1990;147:591-5. PubMed
  7. Rosenbaum JF, Fava M, Falk WE, et al. The antidepressant potential of oral S-adenosyl-l-methionine. Acta Psychiatr Scand 1990;81:432-6. PubMed
  8. Domljan Z, Vrhovac B, Durrigl T, Pucar I. A double-blind trial of ademetionine vs naproxen in activated gonarthrosis. Int J Clin Pharmacol Ther Toxicol 1989;27:329-33.
  9. Konig B. A long-term (two years) clinical trial with S-adenosylmethionine for the treatment of osteoarthritis. Am J Med 1987;83:89-94. PubMed
  10. Lipinski JF, Cohen BM, Frankenburg F, et al. Open trial of S-adenosylmethionine for treatment of depression. Am J Psychiatry 1984;141:448-50.
  11. Almasio P, Bortolini M, Pagliaro L, Coltorti M. Role of S-adenosyl-L-methionine in the treatment of intrahepatic cholestasis. Drugs 1990;40:111-23. PubMed
  12. Friedel HA, Goa KL, Benfield P. S-adenosyl-L-methionine. A review of its pharmacological properties and therapeutic potential in liver dysfunction and affective disorders in relation to its physiological role in cell metabolism. Drugs 1989;38:389-416. PubMed
  13. Bottiglieri T, Hyland K, Reynolds EH. The clinical potential of ademetionine (S-adenosylmethionine) in neurological disorders. Drugs 1994;48:137-52. PubMed
  14. Frezza M, Centini G, Cammareri G, et al. S-adenosylmethionine for the treatment of intrahepatic cholestasis of pregnancy. Results of a controlled clinical trial. Hepatogastroenterology 1990;37:122-5.
  15. Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Same and Rivaroxaban Together: Common Questions

Is it safe to take Same with Rivaroxaban?
We do not list a known interaction between Same and Rivaroxaban. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Same and Rivaroxaban have any of the same side effects?
Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Same and Rivaroxaban combination checked?
Interactions in our licensed database are recorded against drug classes. Rivaroxaban is filed under 5 classifications, and Same has documented interactions with 2 drug classes — none of Rivaroxaban's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Same interact with any other medications?
Yes. Same has 189 documented drug interactions in our database — Rivaroxaban is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Rivaroxaban interact with any supplements?
Yes. Rivaroxaban has documented interactions with 285 supplements in our database — Same is not one of them. The Rivaroxaban interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Same monograph Uses, safety profile, and every drug interaction in one place Rivaroxaban drug information The full plain-English guide to this medication Rivaroxaban supplement interactions Every supplement checked against Rivaroxaban, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 31 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Rivaroxaban and Same?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.