Herb & supplement monograph

Syrian Rue Drug Interactions, Uses, Effectiveness, Safety & More

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Interaction report

Drugs that interact with Syrian Rue

1124 medications have a known interaction with Syrian Rue, graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
6-mercaptopurinePurinethol› Ado-trastuzumab EmtansineKadcyla› Abacavir Sulfate, Dolutegravir, LamivudineTriumeq› Abacavir, LamivudineEpzicom› AbemaciclibVerzenio› Abiraterone› Abiraterone AcetateYonsa, Zytiga› AcalabrutinibCalquence› AcarboseGlucobay, Prandase, Precose› AcebutololRhotral, Sectral› AcepromazineAtravet› AcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength› Acetaminophen, AspirinGemnisyn› Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine› Acetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu› Acetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more› Acetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more› Acetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine› Acetaminophen, Butalbital, CodeineBancap w/ Codeine› Acetaminophen, Butalbital, Codeine PhosphatePhrenilin #3› Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound› Acetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more› Acetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3› Acetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS› Acetaminophen, Caffeine, IsomethepteneMigralam› Acetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual› Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief› Acetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex› Acetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu› Acetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu›
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What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Syrian Rue combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Syrian Rue affects

Every type of medication (drug category) Syrian Rue is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 8 drug categories Syrian Rue interacts with
Anticholinergic DrugsCaffeineCholinergic DrugsCytochrome P450 2d6 (cyp2d6) SubstratesCytochrome P450 3a4 (cyp3a4) SubstratesDopamine AgonistsHepatotoxic DrugsSerotonergic Drugs
Anticholinergic Drugs

Theoretically, Syrian rue might decrease the effects of anticholinergic drugs.
Syrian rue contains harmine. Animal research suggests that intravenous administration of harmine potentiates the effects of acetylcholine or increases acetylcholine levels.

Likelihood Possible Evidence D
Caffeine

Theoretically, taking Syrian rue with caffeine might increase the risk of adverse effects, including tremors.
Syrian rue contains the constituent harmaline. Animal research suggests that a combination of caffeine and harmaline increases the intensity and duration of harmaline-induced tremors.

Likelihood Possible Evidence D
Cholinergic Drugs

Theoretically, Syrian rue might increase the effects and adverse effects of cholinergic drugs.
Syrian rue contains harmine. Animal research suggests that intravenous administration of harmine potentiates the effects of acetylcholine or increases acetylcholine levels.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, Syrian rue might increase the levels and clinical effects of drugs metabolized by CYP2D6.
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.

Likelihood Probable Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, Syrian rue might increase the levels and clinical effects of drugs metabolized by CYP3A4.
Syrian rue contains beta-carboline alkaloids, including harmine, harmol, and harmane. In vitro research suggests that these beta-carboline alkaloids competitively inhibit CYP3A4 enzymes.

Likelihood Possible Evidence D
Dopamine Agonists

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.

Likelihood Possible Evidence D
Hepatotoxic Drugs

Theoretically, high doses of Syrian rue might increase the risk of liver damage when taken with hepatotoxic drugs.
Cases of hepatotoxicity and hepatic failure have been reported in patients who ingested a large quantity (up to 100 grams) of Syrian rue seeds.

Likelihood Possible Evidence D
Serotonergic Drugs

Theoretically, Syrian rue might increase the risk of serotonergic adverse effects, including serotonin syndrome, when taken with serotonergic drugs.
Syrian rue contains harmaline and harmine, which have demonstrated strong, reversible inhibition of monoamine oxidase (MAO) A and weak inhibition of MAO B in animal and in vitro research. This may increase the risk for adverse effects with serotonergic drugs.

Likelihood Possible Evidence D
Monograph

Syrian Rue: Uses, Safety & Side Effects

The bottom line

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.

Scientific name
Peganum harmala
Family
Nitrariaceae
Part used
Seeds (and sometimes roots)
Common forms
Dried seeds, powder, extracts, and traditional dye or incense preparations
People commonly use it for
  • 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

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallBest avoided

It contains potent alkaloids that can cause serious toxicity, especially at higher doses.

PregnancyLikely Unsafe

When used orally. Syrian rue can induce labor. Fetal death has also been reported in patients taking Syrian rue to induce an abortion.

Read the full pregnancy detail
BreastfeedingLikely Unsafe

When used orally. Syrian rue can induce labor. Fetal death has also been reported in patients taking Syrian rue to induce an abortion.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

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Overview

Syrian Rue is a flowering plant known scientifically as Peganum harmala. It grows wild in dry regions of the Middle East, Central Asia, North Africa, and parts of the Mediterranean. It has also spread to dry areas of the Americas, where it is sometimes considered an invasive weed.

The plant has long been used in traditional cultures. Its seeds produce a red dye and are burned as incense in some regions. People have also used the seeds in folk medicine and as a psychoactive substance. The seeds are the part most often used because they are richest in the plant's active compounds.

It is important to know that Syrian Rue is a strong, potentially toxic plant. It is not a gentle, everyday herbal tea, and it should be treated with great caution.

How it works

Syrian Rue seeds contain a group of compounds called harmala alkaloids, mainly harmine, harmaline, and related substances. These compounds are best known for acting as monoamine oxidase inhibitors (MAOIs). MAO is an enzyme that breaks down certain brain chemicals, so blocking it can raise levels of substances like serotonin.

This MAO-inhibiting action is thought to be behind the plant's psychoactive and mood-related effects. The alkaloids have also shown antimicrobial and antiparasitic activity in laboratory tests.

It is important to understand that these mechanisms come largely from lab and animal research. The same MAO-inhibiting activity that may produce effects also makes the plant risky, because it can interact with foods, medicines, and the body in dangerous ways.

Effectiveness

Does Syrian Rue work?

Evidence overview · 6 uses evaluated
6 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.

For Syrian Rue, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 6 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Cancer
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral Syrian rue for cancer, there is insufficient reliable information about the clinical effects of Syrian rue for this purpose.

Insufficient Reliable Evidence To Rate Depression
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral Syrian rue for depression, there is insufficient reliable information about the clinical effects of Syrian rue for this purpose.

Insufficient Reliable Evidence To Rate Diabetes
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral Syrian rue for diabetes, there is insufficient reliable information about the clinical effects of Syrian rue for this purpose.

Insufficient Reliable Evidence To Rate Intestinal parasite infection
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral Syrian rue for intestinal parasite infections, there is insufficient reliable information about the clinical effects of Syrian rue for this purpose.

Insufficient Reliable Evidence To Rate Osteoarthritis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if topical Syrian rue seed extract is beneficial in patients with knee osteoarthritis.

Insufficient Reliable Evidence To Rate Parkinson disease
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral Syrian rue for Parkinson disease, there is insufficient reliable information about the clinical effects of Syrian rue for this purpose.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

Syrian Rue should be considered a potentially dangerous substance, not a routine supplement. Higher doses of the seeds can cause serious poisoning, and there have been reports of severe toxicity and even deaths linked to its use.

People with liver, kidney, heart, or nervous system problems, and anyone taking prescription medications, should be especially cautious and avoid it unless directed by a healthcare professional. Because it acts as an MAO inhibitor, it can have unpredictable and serious effects in the body.

Pregnancy: Avoid Syrian Rue during pregnancy. It has traditionally been used to bring on menstruation or cause abortion, which signals it may harm a pregnancy.

Breastfeeding: Avoid it while breastfeeding. There is no reliable safety information, and its potent alkaloids could pass to the baby.

Always talk to a pharmacist or doctor before using any product that contains Syrian Rue.

Side effects

Reported side effects include nausea, vomiting, dizziness, agitation, hallucinations, blurred vision, and a slowed or irregular heart rate. Some people experience tremors or trouble walking.

More serious reactions can include very low blood pressure, breathing trouble, confusion, seizures, and effects on the heart and nervous system. In high doses, poisoning can be life-threatening and may require emergency medical care.

Because it is an MAO inhibitor, it can also trigger dangerous spikes in blood pressure or a serious condition called serotonin syndrome when combined with certain foods, supplements, or drugs. If someone has severe symptoms after taking it, seek emergency help right away.

Syrian Rue: Reported Adverse Effects

Documented safety reports on Syrian Rue from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, Syrian rue may be unsafe, especially at high doses. Topically, Syrian rue seems to be well tolerated.

Serious Adverse Effects (Rare):

Orally: Acute kidney failure, bradycardia, cerebellar ataxia, cerebral ischemia, hallucinations, hepatic failure, hypertension, peripheral neuropathy, and tachycardia, especially at high doses.

Reports by condition
Cerebellar ataxia Neurologic/CNS
Hypertension Cardiovascular
Kidney failure Renal
Nausea and vomiting Gastrointestinal
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.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no established safe or standardized dose of Syrian Rue for any health condition. Because the plant is potent and potentially toxic, even small differences in amount can be the difference between an effect and poisoning.

Given the lack of reliable dosing and the real risk of harm, we do not recommend a dose. If you are considering any product containing Syrian Rue, read the label carefully and, more importantly, speak with a pharmacist or doctor first.

Pregnancy & Breastfeeding
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

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 17 references that drive our Syrian Rue 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. Yuruktumen, A., Karaduman, S., Bengi, F., and Fowler, J. Syrian rue tea: a recipe for disaster. Clin Toxicol (Phila) 2008;46(8):749-752. PubMed
  2. Kawanishi, K., Hashimoto, Y., Fujiwara, M., Kataoka, Y., and Ueki, S. Pharmacological characteristics of abnormal behavior induced by harmine with special reference to tremor in mice. J Pharmacobiodyn 1981;4(7):520-527. PubMed
  3. Herraiz, T., Gonzalez, D., Ancin-Azpilicueta, C., Aran, V. J., and Guillen, H. beta-Carboline alkaloids in Peganum harmala and inhibition of human monoamine oxidase (MAO). Food Chem Toxicol 2010;48(3):839-845. PubMed
  4. Frison, G., Favretto, D., Zancanaro, F., Fazzin, G., and Ferrara, S. D. A case of beta-carboline alkaloid intoxication following ingestion of Peganum harmala seed extract. Forensic Sci Int 2008;179(2-3):e37-e43.
  5. Slotkin, T. A. and DiStefano, V. Cardiovascular and respiratory effects of harmine. Proc Soc Exp Biol Med 1970;133(2):662-664. PubMed
  6. 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
  7. 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
  8. Fuller, R. W., Wong, C. J., and Hemrick-Luecke, S. K. MD 240928 and harmaline: opposite selectivity in antagonism of the inactivation of types A and B monoamine oxidase by pargyline in mice. Life Sci 1986;38(5):409-412. PubMed
  9. Al-Deeb, S., Al-Moutaery, K., Arshaduddin, M., Biary, N., and Tariq, M. Effect of acute caffeine on severity of harmaline induced tremor in rats. Neurosci Lett 2002;325(3):216-218. PubMed
  10. 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.
  11. Abdel-Fattah, A. F., Matsumoto, K., Murakami, Y., Adel-Khalek, Gammaz H., Mohamed, M. F., and Watanabe, H. Central serotonin level-dependent changes in body temperature following administration of tryptophan to pargyline- and harmaline-pretreated rats. Ge PubMed
  12. Bergstrom, M., Westerberg, G., and Langstrom, B. 11C-harmine as a tracer for monoamine oxidase A (MAO-A): in vitro and in vivo studies. Nucl Med Biol 1997;24(4):287-293. PubMed
  13. Gerardy, J. Effect of moclobemide on rat brain monoamine oxidase A and B: comparison with harmaline and clorgyline. Prog Neuropsychopharmacol Biol Psychiatry 1994;18(4):793-802.
  14. Sacher, J., Houle, S., Parkes, J., Rusjan, P., Sagrati, S., Wilson, A. A., and Meyer, J. H. Monoamine oxidase A inhibitor occupancy during treatment of major depressive episodes with moclobemide or St. John's wort: an [11C]-harmine PET study. J Psychiatry
  15. Berdai MA, Labib S, Harandou M. Peganum harmala L. Intoxication in a Pregnant Woman. Case Rep Emerg Med 2014;2014:783236.
Keep reading

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.

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

Pharmacist Counseling Corner

Syrian Rue: Common Questions

What is Syrian Rue used for, and does it work?
People use Syrian Rue for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Syrian Rue interact with prescription medications?
Yes. We list 1124 medications with a known interaction with Syrian Rue. Use the checker above to see how Syrian Rue interacts with a specific drug.
How are Syrian Rue interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Syrian Rue with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Syrian Rue interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Syrian Rue used for?
Traditionally it has been used for digestive complaints, as a calming or mood-altering agent, as an antimicrobial, and as a dye or incense. There is little solid human evidence that it safely treats any condition.
Is Syrian Rue safe to take?
It is generally considered unsafe to use on your own because its seeds contain potent alkaloids that can cause serious toxicity. We recommend avoiding it unless a healthcare professional advises otherwise.
Can I use Syrian Rue while pregnant or breastfeeding?
No. It should be avoided during pregnancy because it has been used traditionally to cause abortion, and it should be avoided while breastfeeding due to a lack of safety data.
What are the main active compounds in Syrian Rue?
Its seeds are rich in harmala alkaloids such as harmine and harmaline, which act as monoamine oxidase inhibitors (MAOIs) and are responsible for many of its effects and risks.

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

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