Syrian Rue + Galantamine Extended Release
Galantamine Extended Release brand name: Razadyne ER.
Galantamine Extended Release falls into 3 drug categories that Syrian Rue can interact with; the most serious is rated moderate. Theoretically, Syrian rue might increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full interaction reportSyrian Rue and Galantamine Extended Release
These two interact in 3 distinct ways. Each one is explained separately below.
Why Are There 3 Interactions?
Syrian Rue interacts with whole categories of medication. Galantamine Extended Release falls into 3 of those categories, so it can interact with Syrian Rue in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
1 of 3Why this applies to Galantamine Extended Release
Galantamine Extended Release falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Syrian Rue interacts with.
Syrian rue contains beta-carboline alkaloids, including harmine, harmaline, harmalol, harmol, and harmane. In vitro research suggests that these beta-carboline alkaloids can inhibit CYP2D6 enzymes.
Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..
Here's the gist for Razadyne ER (galantamine). Your body relies on a liver enzyme called CYP2D6 to help clear this medicine. Syrian Rue's harmala alkaloids (harmine, harmaline, and friends) appear to slow that enzyme down, at least in lab studies. If CYP2D6 is working slower, galantamine could build up higher than expected in your system.
More galantamine usually means more of its cholinergic effects, so you might notice nausea, vomiting, diarrhea, dizziness, a slow heartbeat, or loss of appetite. Keep in mind this is a theoretical concern based on test-tube data, not real patient reports, so the actual risk is uncertain. Still, Syrian Rue carries its own toxicity risks, so please check with your pharmacist or doctor before combining them.
- Zhao, T., He, Y. Q., Wang, J., Ding, K. M., Wang, C. H., and Wang, Z. T. Inhibition of human cytochrome P450 enzymes 3A4 and 2D6 by β-carboline alkaloids, harmine derivatives. Phytother Res 2011;25(11):1671-1677.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 3Galantamine Extended Release also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Syrian rue contains beta-carboline alkaloids, including harmine, harmol, and harmane. In vitro research suggests that these beta-carboline alkaloids competitively inhibit CYP3A4 enzymes.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
Your body relies on a liver enzyme called CYP3A4 to help clear galantamine from your system. Syrian Rue contains harmala compounds that, at least in lab studies, can slow this same enzyme down. If that happened in real life, galantamine could build up a bit more than expected, which may turn up its typical side effects: nausea, vomiting, diarrhea, dizziness, a slow heartbeat, or loss of appetite.
The good news is that this concern is theoretical and comes from test-tube research, not from people, so we honestly don't know how strong it is. Still, Syrian Rue carries real toxicity risks of its own. Before pairing it with your Razadyne ER, please check with your pharmacist or doctor first.
- Zhao, T., He, Y. Q., Wang, J., Ding, K. M., Wang, C. H., and Wang, Z. T. Inhibition of human cytochrome P450 enzymes 3A4 and 2D6 by β-carboline alkaloids, harmine derivatives. Phytother Res 2011;25(11):1671-1677.
CHOLINERGIC DRUGS
3 of 3Galantamine Extended Release also falls under CHOLINERGIC DRUGS.
Syrian rue contains harmine. Animal research suggests that intravenous administration of harmine potentiates the effects of acetylcholine or increases acetylcholine levels.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
Here's the basic idea with Razadyne ER. Galantamine works by raising acetylcholine, an important nerve-signaling chemical, in the brain. Syrian Rue may push acetylcholine levels up too, based on its harmala alkaloids. So stacking them could, in theory, add up and give you too much cholinergic activity.
When that happens, you might notice more of galantamine's usual side effects: nausea, vomiting, diarrhea, stomach cramps, a slow heartbeat, dizziness, or sweating. I want to be honest, though, that this concern comes from animal studies and pharmacology reasoning, not solid human data, so it's more of a caution flag than a proven problem. Syrian Rue carries its own real toxicity risks regardless. Please check with your pharmacist or doctor before combining them.
- Slotkin, T. A. and DiStefano, V. Cardiovascular and respiratory effects of harmine. Proc Soc Exp Biol Med 1970;133(2):662-664. PubMed
- Javoy, F., Euvrard, C., Herbet, A., Bockaert, J., Enjalbert, A., Agid, Y., and Glowinski, J. Lack of involvement of dopaminergic and GABA neurones in the inhbitory effect of harmaline on the activity of striatal cholinergic neurones in the rat. Naunyn Sch
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
- ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
- PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
- UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
- AHigh-quality meta-analysis (quantitative systematic review).
- BCase-control study.
- CConsensus.
- DAnecdotal evidence.
These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.
Syrian Rue Also Interacts With Other Medications
Syrian Rue has 1,121 moderate known drug interactions in our database — the Galantamine Extended Release one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Syrian Rue
We haven’t checked that one against Syrian Rue yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Syrian Rue. Pick one to open its full report.
See Every Supplement That Interacts With Galantamine Extended Release
This page covers Syrian Rue only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Galantamine Extended Release page lists 170 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), 1,3-dmaa (moderate) and Acacia Rigidula (moderate).
By severity: 3 major · 126 moderate · 41 minor.
From our pharmacist’s overview on the Galantamine Extended Release page
“Galantamine ER (Razadyne ER) treats Alzheimer's dementia by boosting acetylcholine, and because the people taking it are usually older adults already juggling several medicines, its 170 documented supplement interactions warrant genuine care rather than a shrug. Three carry a major rating, and those are the ones to learn first: grapefr…”
Reviewed by 2 · Jul 18, 2026
Where Syrian Rue and Galantamine Extended Release 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.
#741 of 1,452 supplements looked up here in the last 7 days
#2,555 of 2,830 medications looked up here in the last 7 days
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.
About Syrian Rue
What is Syrian Rue?
- Traditional remedy for digestive complaints
- Used as a sedative or for mood
- Antimicrobial and antiparasitic folk use
- Used as a dye and incense
- Recreational psychoactive use
Syrian Rue (Peganum harmala) is a traditional plant whose seeds contain potent compounds called harmala alkaloids, including MAO-inhibiting harmine and harmaline. There is little reliable human evidence that it safely treats any condition, and it carries real risks of toxicity, so it is not recommended for self-treatment. Talk to a pharmacist or doctor before considering it.
Other Drugs & Syrian Rue
Browse every other medication we’ve checked against Syrian Rue — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,121 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Diphenhydramine ›
- Hydrocortisone ›
- Methylphenidate ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Amoxicillin ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Fenofibrate ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Glycopyrrolate ›
- Methyltestosterone ›
- Triazolam ›
- Zopiclone ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Allopurinol ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Ipratropium ›
- Miconazole ›
- Morphine Sulfate ›
- Phenylephrine ›
- Procainamide ›
- Trimipramine ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Dimenhydrinate ›
- Everolimus ›
Showing 60 of 1,121 moderate interactions — see all 1,121 on the Syrian Rue page.
No interaction 1,708 drugs checked — show the list
We also checked Syrian Rue against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Ivermectin ›
- Aspirin ›
- Docusate ›
- Tirzepatide ›
- Ibuprofen ›
- Valacyclovir ›
- Hydroxyurea ›
- Semaglutide ›
- Metformin ›
- Isotretinoin ›
- Lisinopril ›
- Bendamustine ›
- Bupropion ›
- Azithromycin ›
- Acyclovir ›
- Pregabalin ›
- Lamotrigine ›
- Gabapentin ›
- Levothyroxine, Liothyronine ›
- Naproxen ›
- Candesartan Cilexetil ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Cephalexin ›
- Cyclopentolate ›
- Acetylsalicylic Acid ›
- Ezetimibe ›
- Mannitol ›
- Roxithromycin ›
- Levetiracetam ›
- Phentermine, Topiramate ›
- Thyroid Hormone ›
- Spironolactone ›
- Levothyroxine Sodium ›
- Valsartan ›
- Pizotifen ›
- Daptomycin ›
- Canagliflozin, Metformin ›
- Flutemetamol F-18 ›
- Cefaclor ›
- Insulin Degludec, Liraglutide ›
- Hexobarbitone ›
- Mitomycin ›
- Magnesium Hydroxide (otc Drug) ›
- Hethylphenidate Hcl ›
- Pegunigalsidase Alfa-iwxj ›
- Hydroxychloroquine ›
- Minoxidil ›
- Atenolol ›
- Amobarbital, Ephedrine Sulfate ›
- Casanthranol, Docusate ›
- Digoxin ›
- Alginic Acid, Aluminum Hydroxide ›
- Salbutamol Sulfate ›
- Hydrochlorothiazide ›
- Factor 7a ›
- Insulin Human, Sodium Chloride ›
- Sacubitril, Valsartan ›
- Bupivacaine, Meloxicam ›
- Alglucosidase Alpha ›
Showing the 60 most looked-up of 1,708 medications checked with no known interaction — see the full Syrian Rue list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Taking Syrian Rue and Galantamine Extended Release Together: Common Questions
Can you take Syrian Rue with Galantamine Extended Release?
Why are there 3 interactions listed for Syrian Rue and Galantamine Extended Release?
How serious is the Syrian Rue and Galantamine Extended Release interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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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.