Generic Name: selegiline (se-LE-ji-leen)
Brand Name: Emsam
Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using Emsam system outweigh the risks.
Family and caregivers must closely watch patients who take Emsam system. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.
Emsam system is not approved for use in CHILDREN. Emsam system should not be used in children younger than 12 years old at any dose; safety and effectiveness in these children have not been confirmed.
Emsam system is used for:
Treating depression. It may also be used for other conditions as determined by your doctor.
Emsam system is a monoamine oxidase inhibitor (MAOI). Exactly how Emsam system works to treat depression is unknown.
Do NOT use Emsam system if:
- you are allergic to any ingredient in Emsam system
- you are taking fluoxetine or have taken it within the past 5 weeks
- you are taking bupropion, buspirone, cyclobenzaprine, dextromethorphan, meperidine, methadone, a norepinephrine reuptake inhibitor (eg, atomoxetine), propoxyphene, a selective serotonin reuptake inhibitor (SSRI) (eg, paroxetine), a serotonin-norepinephrine reuptake inhibitor (SNRI) (eg, duloxetine, venlafaxine), St. John's wort, a tetracyclic antidepressant (eg, mirtazapine), tramadol, or a tricyclic antidepressant (eg, amitriptyline). You will need to wait for a period of time after you stop these medicines before you start taking Emsam system. If you have been taking 1 of these medicines, check with your doctor to see when you should start Emsam system
- you are taking oral selegiline; another MAOI (eg, phenelzine); linezolid; a sympathomimetic, including an amphetamine, a cold product, or certain diet pills or preparations (eg, ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine); or sibutramine. You will need to wait for a period of time after you stop these medicines before you start taking Emsam system. If you have been taking 1 of these medicines, check with your doctor to see when you should start Emsam system
- you are taking a 5-HT1 agonist (eg, sumatriptan), apraclonidine, carbamazepine, methylphenidate, oxcarbazepine, or nefazodone
- you will be undergoing elective surgery with general anesthesia or will be receiving cocaine or local anesthesia containing sympathomimetic vasoconstrictors
- you have certain adrenal gland problems (eg, pheochromocytoma)
Contact your doctor or health care provider right away if any of these apply to you.
Before using Emsam system:
Some medical conditions may interact with Emsam system. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a history of bipolar disorder, mania, mood or mental problems, suicidal thoughts or attempts, or uncontrolled muscle movements (eg, twitching of the face and tongue, involuntary movements of the arms and legs)
- if you have a history of ulcer, heart problems, recent heart attack, seizures, blood problems, or a metabolism disorder
- if you are taking a medicine that contains methylene blue
Some MEDICINES MAY INTERACT with Emsam system. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Bupropion, cyclobenzaprine, dextromethorphan, linezolid, MAOIs (eg, phenelzine), meperidine, methadone, norepinephrine reuptake inhibitors (eg, atomoxetine), oral selegiline , propoxyphene, sibutramine, SNRIs (eg, duloxetine, venlafaxine), SSRIs (eg, fluoxetine, paroxetine), St. John's wort, sympathomimetics (eg, amphetamine, ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine), tetracyclic antidepressants (eg, mirtazapine), or tricyclic antidepressants (eg, amitriptyline ) because serotonin syndrome (eg, fever, muscle stiffness or rigidity, vital sign changes, mental or mood changes, coma) may occur
- Apraclonidine or buspirone because severe high blood pressure may occur
- Nefazodone or tryptophan because nausea, dizziness, mental or mood changes, seizures, fever, or breathing or heart problems may occur
- Tramadol because the risk of seizures may be increased
- Carbamazepine or oxcarbazepine because they may increase the risk of Emsam system's side effects
- 5-HT1 agonists (eg, sumatriptan), insulin, a meglitinide antidiabetic (eg, nateglinide), methylphenidate, or sulfonylureas (eg, glipizide) because the risk of their side effects may be increased by Emsam system
This may not be a complete list of all interactions that may occur. Ask your health care provider if Emsam system may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use Emsam system:
Use Emsam system as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Emsam system comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Emsam system refilled.
- Wear only 1 patch at a time. Remove a used patch before applying a new one. Change the patch at about the same time each day.
- Do not cut or tear the patch. Do not apply to an area of skin that is hairy, oily, irritated, broken, scarred, or calloused. Do not place the patch under tight clothing.
- Apply to dry, smooth, intact skin on the upper torso, upper thigh, or outer surface of the upper arm. Use a new application site with each new patch.
- Wash the area gently with soap and warm water before applying the patch. Rinse until all soap is removed. Dry the area with a clean, dry towel.
- Apply the patch as directed by your doctor or on the package labeling. Apply the patch immediately upon removal from the protective pouch. If you have questions about how to apply the patch, check with your doctor or pharmacist.
- Wash your hands thoroughly with soap and water after applying the patch. Do not touch your eyes until after you have washed your hands.
- Avoid exposing the application site to direct heat, such as heating pads or electric blankets, heat lamps, saunas, hot tubs, heated water beds, and prolonged direct sunlight.
- After 24 hours, remove the used patch. After removing the used patch, fold it in half with the sticky sides together. Discard the patch out of the reach of children and away from pets. Wash your hands with soap and water after removing the patch.
- If your doctor tells you to stop taking Emsam system, you will need to wait at least 14 days before beginning to take certain other medicines (eg, medicines for depression, anxiety, pain, cough, congestion, weight loss, seizures, or Parkinson disease; muscle relaxants). Ask your doctor if you are unsure when you should start to take your new medicines after you have stopped taking Emsam system.
- Continue to use Emsam system even if you feel well. Do not miss any doses.
- If your patch falls off or if you miss a dose of Emsam system, apply a new patch to a new site and resume your previous schedule.
Ask your health care provider any questions you may have about how to use Emsam system.
Important safety information:
- Emsam system may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Emsam system with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Do not drink alcohol while you are using Emsam system.
- Emsam system may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Do not suddenly stop using Emsam system. The risk of side effects may be increased if Emsam system is suddenly stopped. Check with your doctor before you change your dose or stop Emsam system.
- Some people have experienced new, unusual, or increased urges (eg, gambling, sexual) while using Emsam system. Tell your doctor right away if you notice such effects.
- Children, teenagers, and young adults who take Emsam system may be at increased risk for suicidal thoughts or actions. Watch patients who take Emsam system closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
- The oral form of Emsam system is used to treat Parkinson disease. Patients with Parkinson disease have an increased risk of developing a certain type of skin cancer (melanoma). It is not known if Emsam system may contribute to the increased risk of melanoma. You may need to have skin exams while you are using Emsam system. Discuss any questions or concerns with your doctor.
- Serotonin syndrome is a possibly fatal syndrome that can occur if you take Emsam system with certain other medicines (eg, dextromethorphan, SSRIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
- Eating foods high in tyramine (eg, aged cheeses, red wines, beer, certain meats and sausages, liver, sour cream, soy sauce, raisins, bananas, avocados) while you use an MAOI may cause severe high blood pressure. This could occur for up to 2 weeks after you stop taking an MAOI. Do not eat foods high in tyramine while you take Emsam system. Ask your health care provider for a complete list of foods you should avoid. Seek medical attention at once if symptoms of severe high blood pressure occur. These may include severe headache, fast or irregular heartbeat, sore or stiff neck, nausea, vomiting, sweating, enlarged pupils, or sensitivity to light.
- Avoid dietary supplements containing tyramine or nonprescription products containing dextromethorphan, pseudoephedrine, or phenylephrine while you are using Emsam system.
- Tell your doctor or dentist that you take Emsam system before you receive any medical or dental care, emergency care, or surgery. Emsam system should be discontinued at least 10 days before elective surgery.
- Diabetes patients - Emsam system may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Lab tests, including blood pressure and skin checks, may be performed while you use Emsam system. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use Emsam system with caution in the ELDERLY; they may be more sensitive to its effects, especially rash.
- Use Emsam system with extreme caution in children younger than 18 years old; safety and effectiveness in these children have not been confirmed.
- Emsam system should not be used in CHILDREN younger than 12 years old; safety and effectiveness in these children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Emsam system while you are pregnant. It is not known if Emsam system is found in breast milk. If you are or will be breast-feeding while you use Emsam system, check with your doctor. Discuss any possible risks to your baby.
Possible side effects of Emsam system:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Diarrhea; dizziness; dry mouth; mild redness at the application site; sleeplessness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal thinking; changes in sexual ability or desire; chest pain; confusion; dark or unusual growths on the skin or any skin changes; enlarged pupils; fast, slow, or irregular heartbeat; fever; increased sweating; memory loss; nausea; neck stiffness or soreness; new or worsening agitation, aggressiveness, anxiety, depression, exaggerated feeling of well-being, hostility, impulsiveness, inability to sit still, irritability, panic attacks, or sleeplessness; painful menstruation; rigid muscles; sensitivity to light; severe or persistent dizziness or headache; severe or persistent redness or itching at the application site; suicidal thoughts or actions; swelling of the arms or legs; tremor; unusual or intense urges (eg, gambling, sexual); vomiting.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org ), or emergency room immediately. Symptoms may include coma; cool, clammy skin; difficulty breathing; excessive sweating; fast or irregular heartbeat; fever; hallucinations; hyperactivity; seizures; severe dizziness, drowsiness, or headache.Proper storage of Emsam system:
Store Emsam system at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Do not store the patch outside of the sealed pouch. Store away from heat, moisture, and light. Keep Emsam system out of the reach of children and away from pets.
- If you have any questions about Emsam system, please talk with your doctor, pharmacist, or other health care provider.
- Emsam system is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take Emsam system or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Emsam system. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Emsam system. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Emsam system.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.