WARNING

Emsam (selegiline) is a medication primarily used to treat depression. While it can be effective for many people, there are potential risks and side effects associated with its use. Some of the risks of taking Emsam include:

• Serotonin syndrome: Emsam can increase serotonin levels in the brain, which may lead to a potentially life-threatening condition known as serotonin syndrome. Symptoms include confusion, agitation, rapid heartbeat, high blood pressure, fever, sweating, tremors, and in severe cases, seizures or coma.
• Hypertensive crisis: Emsam can interact with certain foods and medications to cause a sudden and severe increase in blood pressure, known as a hypertensive crisis. Foods high in tyramine, such as aged cheeses, cured meats, and some fermented foods, as well as certain medications like decongestants and stimulants, can trigger this reaction.
• Drug interactions: Emsam can interact with a variety of medications, including other antidepressants, certain pain medications, and drugs used to treat Parkinson’s disease. These interactions can increase the risk of side effects or reduce the effectiveness of either medication.
• Side effects: Common side effects of Emsam include insomnia, headache, dry mouth, nausea, and skin irritation at the application site. Some people may also experience dizziness, weight loss, or sexual dysfunction.
• Withdrawal symptoms: Stopping Emsam suddenly can lead to withdrawal symptoms, including mood swings, anxiety, dizziness, and flu-like symptoms. It’s important to taper off the medication under the guidance of a healthcare professional.

It’s essential for anyone considering taking Emsam to discuss the potential risks and benefits with their healthcare provider, especially if they have any pre-existing medical conditions or are taking other medications. Close monitoring is necessary to ensure the medication is safe and effective for each individual.

Why is this medication prescribed?

Emsam (selegiline) is prescribed primarily for the treatment of depression, specifically major depressive disorder (MDD). It belongs to a class of medications known as monoamine oxidase inhibitors (MAOIs), which work by increasing the levels of certain chemicals in the brain that regulate mood.

How should this medicine be used?

Emsam (selegiline) is a medication typically used to treat depression. It comes in the form of a transdermal patch, which is applied to the skin. Here’s how Emsam should be used:

• Choosing the application site: Select a clean, dry, and hairless area of skin on the upper torso (such as the chest, upper back, or outer side of the upper arm). Avoid areas with cuts, irritation, or rashes.
• Preparing the skin: Clean the chosen area of skin with water and mild soap. Make sure the skin is completely dry before applying the patch.
• Opening the package: Remove the patch from its individual package just before applying it. Avoid cutting or damaging the patch during this process.
• Applying the patch: Peel off the protective liner from one side of the patch, being careful not to touch the adhesive side with your fingers. Press the sticky side of the patch firmly onto the chosen area of skin. Then, peel off the protective liner from the other side and press the entire patch firmly into place.
• Securing the patch: Smooth down the edges of the patch to ensure it adheres well to the skin. Make sure there are no wrinkles or folds in the patch.
• Changing the patch: Replace the patch with a new one every 24 hours. Choose a different area of skin each day to avoid irritation. Rotate the application sites to prevent skin irritation from repeated use in the same area.
• Avoiding water: Try to keep the patch dry while bathing, swimming, or engaging in activities that may cause sweating. If the patch becomes loose or falls off, replace it with a new one.
• Following dietary restrictions: While using Emsam, it’s important to follow dietary restrictions to avoid foods and beverages high in tyramine, as they can interact with the medication and cause dangerous increases in blood pressure. Your healthcare provider will provide you with a list of foods to avoid.
• Consulting your healthcare provider: Always follow the dosage and usage instructions provided by your healthcare provider. If you have any questions or concerns about how to use Emsam, consult your healthcare provider or pharmacist for guidance.

By following these steps and guidelines, you can effectively use Emsam to manage your depression as prescribed by your healthcare provider.

Other uses for this medicine

In addition to treating depression, Emsam (selegiline) may also be used off-label or in certain cases for other conditions, including:

• Parkinson’s disease: Selegiline, the active ingredient in Emsam, is also used in higher doses to treat Parkinson’s disease. It works by increasing the levels of dopamine in the brain, which helps to alleviate symptoms of Parkinson’s.
• Social anxiety disorder (SAD): Some studies have suggested that selegiline may be helpful in the treatment of social anxiety disorder, although this is not an FDA-approved indication.
• Attention deficit hyperactivity disorder (ADHD): There is some evidence to suggest that selegiline may have potential in the treatment of ADHD, particularly in adults, but more research is needed in this area.

What special precautions should I follow?

As for special precautions when using Emsam, here are some important points to consider:

• Dietary restrictions: Emsam is an MAOI (monoamine oxidase inhibitor), and certain foods and beverages high in tyramine can interact with MAOIs and cause a dangerous increase in blood pressure known as hypertensive crisis. Foods to avoid include aged cheeses, cured meats, fermented foods, certain alcoholic beverages, and some types of beans. Your healthcare provider will provide you with a complete list of foods to avoid while taking Emsam.
• Medication interactions: Emsam can interact with a wide range of medications, including other antidepressants, certain pain medications, cold and allergy medications, and drugs used to treat Parkinson’s disease. Inform your healthcare provider about all medications (including prescription, over-the-counter, and herbal supplements) that you are taking before starting Emsam.
• Hypertensive crisis: In addition to dietary restrictions, certain medications can also cause a hypertensive crisis when taken with Emsam. These include sympathomimetic agents (such as decongestants and stimulants), certain antidepressants, and other MAOIs. Avoid taking these medications while using Emsam unless directed by your healthcare provider.
• Withdrawal symptoms: If you need to stop taking Emsam, it’s important to do so gradually under the supervision of your healthcare provider to avoid withdrawal symptoms such as mood swings, anxiety, dizziness, and flu-like symptoms.
• Skin irritation: Skin reactions such as redness, itching, or rash may occur at the application site with the use of the transdermal patch. Rotate application sites and consult your healthcare provider if irritation persists.
• Monitoring: Regular monitoring by your healthcare provider is important while taking Emsam to ensure that it is safe and effective for you. Be sure to attend all scheduled appointments and report any side effects or concerns to your healthcare provider promptly.

By following these precautions and guidelines, you can safely and effectively use Emsam to manage your condition under the supervision of your healthcare provider.

What special dietary instructions should I follow?

Special dietary instructions to follow while taking Emsam include:

• Avoiding foods high in tyramine: Certain foods and beverages high in tyramine can interact with Emsam and cause a hypertensive crisis. Foods to avoid include aged cheeses, cured meats, fermented foods, certain alcoholic beverages, and some types of beans.
• Read food labels: Check the labels of packaged and processed foods for ingredients that may contain tyramine, such as yeast extracts, soy sauce, and certain flavor enhancers.
• Follow your healthcare provider’s recommendations: Your healthcare provider will provide you with specific dietary instructions while taking Emsam. Follow these instructions carefully to minimize the risk of interactions and side effects.

What should I do if I forget a dose?

If you forget to apply a dose of Emsam, apply it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not apply extra patches to make up for a missed dose. If you have any concerns or questions about missed doses, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Emsam (selegiline) can cause various side effects, ranging from mild to severe. Common side effects may include:

• Skin irritation: Redness, itching, or rash at the site where the patch is applied is common.
• Insomnia: Difficulty falling asleep or staying asleep may occur.
• Headache: Mild to moderate headaches are reported by some individuals.
• Dry mouth: Some people may experience a dry sensation in the mouth.
• Nausea: Mild stomach discomfort or nausea may occur, especially when first starting the medication.
• Dizziness: Feeling lightheaded or dizzy may occur, particularly when standing up quickly.
• Weight loss: Some individuals may experience a decrease in appetite and subsequent weight loss.
• Sexual dysfunction: Changes in libido or sexual function may occur in some individuals.

Less common but more serious side effects may include:

• Serotonin syndrome: This is a rare but potentially life-threatening condition characterized by symptoms such as confusion, agitation, rapid heartbeat, high blood pressure, fever, sweating, tremors, and in severe cases, seizures or coma. Seek immediate medical attention if you experience any of these symptoms.
• Hypertensive crisis: Emsam can interact with certain foods and medications to cause a sudden and severe increase in blood pressure. Symptoms may include severe headache, rapid heartbeat, chest pain, nausea, vomiting, and confusion. If you experience any of these symptoms, seek immediate medical attention.
• Allergic reaction: Some individuals may experience an allergic reaction to Emsam, characterized by rash, itching, swelling, severe dizziness, or difficulty breathing. Seek immediate medical attention if you experience any signs of an allergic reaction.

It’s important to report any side effects to your healthcare provider, especially if they are persistent or severe. Your healthcare provider can help manage side effects and adjust your treatment plan if necessary. Additionally, do not stop taking Emsam abruptly without consulting your healthcare provider, as this can lead to withdrawal symptoms.

What should I know about storage and disposal of this medication?

Storage and disposal of Emsam (selegiline):

• Storage: Store Emsam patches at room temperature away from moisture, heat, and light. Keep the patches in their original packaging until ready to use. Do not store Emsam patches in the bathroom. Keep all medications out of reach of children and pets.
• Disposal: Dispose of used Emsam patches by folding them in half with the sticky sides together and safely disposing of them in a trash can out of the reach of children and pets. Do not flush Emsam patches down the toilet.

In case of emergency/overdose

In case of emergency or overdose of Emsam:

• Seek medical attention: If you or someone else may have overdosed on Emsam, or if you experience symptoms such as severe headache, rapid heartbeat, chest pain, nausea, vomiting, confusion, agitation, or seizures, seek immediate medical attention.
• Call emergency services: In the United States, you can call the National Poison Control Center at 1-800-222-1222 for guidance on what to do in case of an overdose.

What other information should I know?

• Follow your healthcare provider’s instructions: Take Emsam exactly as prescribed by your healthcare provider. Do not change your dose or stop taking the medication without first consulting your healthcare provider.
• Keep appointments: Attend all scheduled appointments with your healthcare provider for monitoring and evaluation of your condition while taking Emsam.
• Notify healthcare providers: Inform all healthcare providers involved in your care, including dentists and surgeons, that you are taking Emsam. Certain medications and procedures may need to be adjusted or avoided while taking Emsam.
• Avoid alcohol: Limit or avoid alcohol while taking Emsam, as it can increase the risk of side effects and may interact with the medication.
• Pregnancy and breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of taking Emsam with your healthcare provider before starting or continuing treatment.
• Keep a list of medications: Maintain a list of all medications you are taking, including prescription, over-the-counter, and herbal supplements, and share it with your healthcare provider to avoid potential interactions.
• Report side effects: Report any side effects or concerns to your healthcare provider promptly. Your healthcare provider can help manage side effects and adjust your treatment plan if necessary.

By following these guidelines and communicating openly with your healthcare provider, you can safely and effectively use Emsam to manage your condition.