Ademetionine is also is called as S-adenosylmethionine.

Ademetionine is used for treating chronic liver disease such as intrahepatic cholestasis, a condition related to reduced bile flow resulting in accumulation. It is also used to treat mood disorders such as depression, osteoarthritis, and muscle pain or fibromyalgia.  

• Ademetionine is contraindicated in patients with bipolar depression because of reports of increased anxiety and mania.
• It should also not be used in patients allergic to the drug.

Depression
• Oral: 400-1600 mg per day
• IM/IV: 200-400 mg/day

Osteoarthritis
• Oral: 200 mg thrice daily
• IV: 400 mg/day

Liver Disease, Alcohol Related
• Oral: 1200-1600 mg per day; should not be administered for more than 2 years
• IV: 200-2000 mg/day for 15-30 days
• IM: 200 mg/day for 30 days

Intrahepatic Cholestasis
• Oral: 800 mg twice a day

Fibromyalgia
• 800 mg per day

• Ademetionine tablets should be swallowed whole.
• For better absorption of ademetionine and complete therapeutic effect, ademetionine tablets should not be taken with meals.

• Caution is advised in patients with kidney disease.
• Its use should be avoided in pregnancy especially in the first trimester; should be used only on the advice of a health care provider.
• It should also be avoided during breastfeeding.

•  Gastrointestinal disorders: Vomiting, gas, constipation, diarrhea, loss of appetite, dry mouth
•  Nervous system disorders: Headache, insomnia, dizziness, nervousness
•  Serotonin syndrome: Symptoms include confusion, anxiety, tremors, diarrhea, high blood pressure and seizures
•  Others: Sweating, skin rashes, allergic reaction which could include anaphylactic reaction

• Ademetionine should be used under the supervision of a physician.
• Folate and vitamin b12 deficiencies may decrease ademetionine levels; therefore patients at risk of these deficiencies should routinely check their vitamin B12 and folic acid level while taking ademetionine.
• Ademetionine should not be used in children and should be stopped at least two weeks before surgery.
• Ammonia levels should be monitored in patients with liver disease taking the medication.

• Ademetionine can precipitate serotonin syndrome when administered with antidepressant drugs like fluoxetine, sertraline and clomipramine, monoamine oxidase inhibitors like phenelzine and tranylcypromine, and supplements like St.John's wort.
• It should not be used in patients taking antidiabetes medication since it cause a severe reduction in blood sugar levels.

• Store at temperatures not exceeding 30°C.