Drug & supplement interaction

Syrian Rue + Rotigotine

Rotigotine brand name: Neupro.

Moderate Interaction
The bottom line Moderate

Syrian Rue has a moderate interaction with Rotigotine. Theoretically, Syrian rue might increase the adverse effects of dopamine agonists.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Syrian Rue and Rotigotine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

DOPAMINE AGONISTS

Why this applies to Rotigotine

Rotigotine falls under DOPAMINE AGONISTS — the group Syrian Rue interacts with.

Theoretically, Syrian rue might increase the adverse effects of dopamine agonists.
Syrian rue contains the constituent harmine. Animal research shows that harmine increases extracellular dopamine levels. The clinical significance of this effect is unclear.
Severity Moderate Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: Rotigotine (Neupro) is a dopamine agonist, meaning it acts like dopamine in your brain to ease Parkinson's symptoms or restless legs. Syrian Rue contains harmine, which in animal studies appears to nudge dopamine levels up. So the theoretical worry is that stacking the two could pile on a little extra dopamine activity.

If that happened, you might notice more of rotigotine's usual side effects, such as nausea, dizziness, lightheadedness when standing, sleepiness or sudden sleep, or unusual urges. I want to be honest, though: this is based on lab and animal data, not real patient studies, so the actual risk in people isn't clear. Syrian Rue also carries its own toxicity concerns. Please loop in your pharmacist or doctor before combining them.

References
  1. Iurlo, M., Leone, G., Schilstrom, B., Linner, L., Nomikos, G., Hertel, P., Silvestrini, B., and Svensson, H. Effects of harmine on dopamine output and metabolism in rat striatum: role of monoamine oxidase-A inhibition. Psychopharmacology (Berl) 2001;159(1 PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • 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.
Evidence the quality of the studies behind the rating (graded A–D)
  • 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.

Keep it in perspective

Syrian Rue Also Interacts With Other Medications

Syrian Rue has 1,121 moderate known drug interactions in our database — the Rotigotine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Syrian Rue

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

Everything else you take

See Every Supplement That Interacts With Rotigotine

This page covers Syrian Rue only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Rotigotine page lists 7 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Ayahuasca (moderate), Black Horehound (moderate), Dimethylsulfoxide (dmso) (moderate), Turpentine Oil (moderate) and Vitex Agnus-castus (moderate).

By severity: 6 moderate · 1 minor.

From our pharmacist’s overview on the Rotigotine page

“Rotigotine (Neupro) treats Parkinson's disease and restless legs through a skin patch, and the seven supplement interactions on file split along those two facts. None rates major, six are moderate and one minor, so this reads as a watch list rather than a stop list.”

Reviewed by 2 · Jul 18, 2026

Open the Rotigotine interaction page

How much people look this up

Where Syrian Rue and Rotigotine 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 Syrian Rue
Steady interest

#1,037 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Rotigotine
Top half

#725 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.

Supplement

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.

Read the full Syrian Rue monograph & all interactions
Medication

About Rotigotine Transdermal Patch

What Is Rotigotine Transdermal Patch Used For?

Brand name: Neupro

Neupro (rotigotine transdermal patch) is approved to treat Parkinson's disease — both early-stage and advanced-stage. It helps manage the movement-related symptoms of Parkinson's by stimulating dopamine receptors in the brain.

Neupro is also approved to treat moderate-to-severe primary Restless Legs Syndrome (RLS) — an uncomfortable urge to move the legs, often worse at night, that isn't caused by another medical condition.

See full Rotigotine Transdermal Patch drug information
Keep checking

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.

0Major
1,121Moderate
0Minor
1,708No known interaction
Moderate

1,121 interactions

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
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

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

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Pharmacist Counseling Corner

Taking Syrian Rue and Rotigotine Together: Common Questions

Can you take Syrian Rue with Rotigotine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Syrian Rue and Rotigotine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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.