Syrian Rue Drug Interactions, Uses, Effectiveness, Safety & More
What is this page for?
First and foremost: how Syrian Rue interacts with medications. The heart of this page is the interaction list — every drug Syrian Rue is known to interact with, and how serious each one is.
But these pages have grown well beyond that into a full monograph — what Syrian Rue is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy
Check Syrian Rue against your medication
Add one medicationDrugs 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.
Don’t want to scroll the list? Just ask.
Tell us the medications you take and we’ll check each one against Syrian Rue using our pharmacist-reviewed interaction data.
AI summaries are generated from our Syrian Rue interaction data for education only — always confirm with your pharmacist. How we use AI
No drugs match “”.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
Syrian Rue: Uses, Safety & Side Effects
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
- 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.
It contains potent alkaloids that can cause serious toxicity, especially at higher doses.
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 detailWhen 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 detailPregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.
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.
Does Syrian Rue work?
How to read these evidence grades
Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.
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
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
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
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
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
It is unclear if topical Syrian rue seed extract is beneficial in patients with knee osteoarthritis.
Insufficient Reliable Evidence To Rate Parkinson disease
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.
Cerebellar ataxia Neurologic/CNS
Orally, intake of Syrian rue seeds 3-4 grams can cause stimulant effects. Intake of larger amounts of Syrian rue seeds can cause more severe neurologic effects. Cases of neurotoxicity, involving disturbances of consciousness, somnolence, cerebellar ataxia, cerebral ischemia, severe peripheral polyneuropathy, diffuse tremors, and coma have been reported in patients who took a large amount of Syrian rue seeds.
- Yuruktumen, A., Karaduman, S., Bengi, F., and Fowler, J. Syrian rue tea: a recipe for disaster. Clin Toxicol (Phila) 2008;46(8):749-752.
- 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.
- Berdai MA, Labib S, Harandou M. Peganum harmala L. Intoxication in a Pregnant Woman. Case Rep Emerg Med 2014;2014:783236.
- Ghizlane EA, Manal M, Ines HA, et al. Fatal poisoning of pregnant women by peganum harmala L.: a case reports. Ann Med Surg (Lond) 2021;68:102649.
- Durmaz Çelik N, Ger Akarsu F, Ozkan S, Özdemir AÖ, Aykac Ö, Memmedova F. Herbal teas can be harmful: a case of Peganum harmala induced coma in a patient with Parkinson's disease. Neurocase 2021;27(2):117-119.
Hypertension Cardiovascular
Orally, hypertension, tachycardia, and bradycardia have been reported in patients taking high doses of Syrian rue seeds. In two cases, the amount of Syrian rue seeds consumed was 100 grams.
- Yuruktumen, A., Karaduman, S., Bengi, F., and Fowler, J. Syrian rue tea: a recipe for disaster. Clin Toxicol (Phila) 2008;46(8):749-752.
- Ghizlane EA, Manal M, Ines HA, et al. Fatal poisoning of pregnant women by peganum harmala L.: a case reports. Ann Med Surg (Lond) 2021;68:102649.
- Durmaz Çelik N, Ger Akarsu F, Ozkan S, Özdemir AÖ, Aykac Ö, Memmedova F. Herbal teas can be harmful: a case of Peganum harmala induced coma in a patient with Parkinson's disease. Neurocase 2021;27(2):117-119.
Kidney failure Renal
Orally, abnormal kidney function tests and acute kidney failure have been reported in patients taking high doses of Syrian rue seeds. In one case, the amount of seeds consumed was 100 grams.
- Yuruktumen, A., Karaduman, S., Bengi, F., and Fowler, J. Syrian rue tea: a recipe for disaster. Clin Toxicol (Phila) 2008;46(8):749-752.
- Berdai MA, Labib S, Harandou M. Peganum harmala L. Intoxication in a Pregnant Woman. Case Rep Emerg Med 2014;2014:783236.
- Ghizlane EA, Manal M, Ines HA, et al. Fatal poisoning of pregnant women by peganum harmala L.: a case reports. Ann Med Surg (Lond) 2021;68:102649.
Nausea and vomiting Gastrointestinal
Orally, Syrian rue seeds can cause nausea and vomiting at high doses.
- 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.
- Ghizlane EA, Manal M, Ines HA, et al. Fatal poisoning of pregnant women by peganum harmala L.: a case reports. Ann Med Surg (Lond) 2021;68:102649.
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.
Syrian Rue & Pregnancy
Syrian Rue & Breastfeeding
© 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.
- 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
- 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
- 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
- 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.
- Slotkin, T. A. and DiStefano, V. Cardiovascular and respiratory effects of harmine. Proc Soc Exp Biol Med 1970;133(2):662-664. PubMed
- 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
- 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
- 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
- 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
- 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.
- 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
- 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
- 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.
- 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
- Berdai MA, Labib S, Harandou M. Peganum harmala L. Intoxication in a Pregnant Woman. Case Rep Emerg Med 2014;2014:783236.
- Ghizlane EA, Manal M, Ines HA, et al. Fatal poisoning of pregnant women by peganum harmala L.: a case reports. Ann Med Surg (Lond) 2021;68:102649. PubMed
- Durmaz Çelik N, Ger Akarsu F, Ozkan S, Özdemir AÖ, Aykac Ö, Memmedova F. Herbal teas can be harmful: a case of Peganum harmala induced coma in a patient with Parkinson's disease. Neurocase 2021;27(2):117-119.
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
Syrian Rue: Common Questions
What is Syrian Rue used for, and does it work?
Does Syrian Rue interact with prescription medications?
How are Syrian Rue interactions rated?
Is it safe to take Syrian Rue with my medications?
Where does this Syrian Rue interaction information come from?
What is Syrian Rue used for?
Is Syrian Rue safe to take?
Can I use Syrian Rue while pregnant or breastfeeding?
What are the main active compounds in Syrian Rue?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Have a question about Syrian Rue?
Our pharmacists answer your medication & supplement questions — free.