Ademetionine Chemical formula
Synonyms: Ademethionine; Ademetioniini; Adémétionin; Ademetionin; Ademetionina; Ademetioninum; S-Adenosylthioninyl adenylate; SAMe. (S)-5′-[(3-Amino-3-carboxypropyl)methylsulphonio]-5′-deoxyadenosine hydroxide, inner salt.
Cyrillic synonym: Адеметионин.

💊 Chemical information

Chemical formula: C15H22N6O5S = 398.4.
CAS — 29908-03-0; 485-80-3; 17176-17-9.
ATC — A16AA02.
ATC Vet — QA16AA02.

💊 Profile

Ademetionine is a naturally occurring molecule found in virtually all body tissues and fluids. It acts as a methyl group donor in many transmethylation reactions and therefore is involved in the synthesis or metabolism of a wide range of compounds that maintain normal cell function. Ademetionine sulfate tosilate and ademetionine butanedisulfonate are stable forms of ademetionine that have been used for the treatment of depression (see below), liver disorders, and osteoarthritis.
1. Bottiglieri T, et al. The clinical potential of ademetionine (S-adenosylmethionine) in neurological disorders. Drugs 1994; 48: 137–52
2. Chavez M. SAMe: S-adenosylmethionine. Am J Health-Syst Pharm 2000; 57: 119–23
3. Fetrow CW, Avila JR. Efficacy of the dietary supplement S-adenosyl-L-methionine. Ann Pharmacother 2001; 35: 1414–25
4. Bottiglieri T. S-Adenosyl-L-methionine (SAMe): from the bench to the bedside—molecular basis of a pleiotrophic molecule. Am J Clin Nutr 2002; 76 (suppl): 1151S–1157S
5. Gören JL, et al. Bioavailability and lack of toxicity of S-adenosyl-L-methionine (SAMe) in humans. Pharmacotherapy 2004; 24: 1501–7.


Ademetionine has been given orally or parenterally in the management of depression. It appears to be of similar efficacy to the tricyclic antidepressants but evidence is limited to small, heterogeneous groups of patients studied over short periods of time; additionally many studies have involved parenteral rather than oral therapy.
1. Bressa GM. S-Adenosyl-1-methionine (SAMe) as antidepressant: meta-analysis of clinical studies. Acta Neurol Scand 1994; 154 (suppl): 7–14
2. Anonymous. SAMe for depression. Med Lett Drugs Ther 1999; 41: 107–8
3. Mischoulon D, Fava M. Role of S-adenosyl-methionine in the treatment of depression: a review of the evidence. Am J Clin Nutr 2002; 76: 1158S–1161S
4. Papakostas GI, et al. S-Adenosyl-methionine in depression: a comprehensive review of the literature. Curr Psychiatry Rep 2003; 5: 460–6.

Liver disorders.

Some workers have found that ademetionine produced clinical improvement in patients with intrahepatic cholestasis,1,2 including that associated with pregnancy.3,4 Pruritus associated with the condition has also been relieved. Other studies,5,6 however, have not found any benefit. Ademetionine produced a good or excellent clinical response in patients with hepatic steatosis.7 In a study8 of patients with alcoholic liver cirrhosis, treated with ademetionine for 2 years, there was a trend towards reduced overall mortality or need for liver transplantation, but only in patients with less severe hepatic dysfunction. However, a systematic review9 of 9 randomised placebo-controlled studies, which included the latter study could not find evidence to support or refute the claim that ademetionine has a beneficial effect in patients with alcoholic liver diseases, and larger high quality randomised placebo-controlled studies are needed.
1. Frezza M, et al. Oral S-adenosylmethionine in the symptomatic treatment of intrahepatic cholestasis: a double-blind, placebocontrolled study. Gastroenterology 1990; 99: 211–15
2. Almasio P, et al. Role of S-adenosyl-methionine in the treatment of intrahepatic cholestasis. Drugs 1990; 40 (suppl 3): 111–23
3. Bonfirraro G, et al. S-Adenosyl- -methionine (SAMe)-induced amelioration of intrahepatic cholestasis of pregnancy: results of an open study. Drug Invest 1990; 2: 125–8
4. Frezza M, et al. S-Adenosylmethionine for the treatment of intrahepatic cholestasis of pregnancy: results of a controlled clinical trial. Hepatogastroenterology 1990; 37 (suppl 2): 122–5
5. Ribalta J, et al. S-Adenosyl-L-methionine in the treatment of patients with intrahepatic cholestasis of pregnancy: a randomized, double-blind, placebo-controlled study with negative results. Hepatology 1991; 13: 1084–9
6. Floreani A, et al. S-Adenosylmethionine versus ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy: preliminary results of a controlled trial. Eur J Obstet Gynecol Reprod Biol 1996; 67: 109–13
7. Caballeria E, Moreno J. Therapeutic effects of S-adenosylmethionine (SAMe) in hepatic steatosis. Acta Ther 1990; 16: 253–64
8. Mato JM, et al. S-Adenosylmethionine in alcoholic liver cirrhosis: a randomized, placebo-controlled, double-blind, multicenter clinical trial. J Hepatol 1999; 30: 1081–9
9. Rambaldi A, Gluud C. S-Adenosyl-L-methionine for alcoholic liver diseases. Available in The Cochrane Database of Systematic Reviews; Issu
2. Chichester: John Wiley; 2006 (accessed 01/04/08).


Ademetionine has been reported to possess therapeutic efficacy in the treatment of osteoarthritis and similar conditions, possibly due to an effect on cartilage metabolism and formation of anti-inflammatory mediators within the cell; it may also inhibit leukotrienes but does not appear markedly to interfere with prostaglandin synthesis.
1. Domljan Z, et al. A double-blind trial of ademethionine vs naproxen in activated gonarthrosis. Int J Clin Pharmacol Ther Toxic ol 1989; 27: 329–33
2. Bradley JD, 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
3. Soeken KL, et al. Safety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritis. J Fam Pract 2002; 51: 425–30
4. Najm WI, et al. S-Adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: a double-blind cross-over trial. BMC Musculoskelet Disord 2004; 5: 6.

💊 Preparations

Proprietary Preparations

Arg.: Transmetil†; Tunik; Austral.: MoodLift†; Cz.: Transmet il ; Ger.: Gumbaral; Ital.: Donamet; Isimet†; Samyr; Transmetil; Mex.: Samyr; Rus.: Heptor (Гептор); Heptral (Гептрал); Spain: S Amet†. Multi-ingredient: Arg.: Tunik B12.
Published October 30, 2018.