selegiline

Pronunciation

Generic Name: selegiline (transdermal) (se LE ji leen (trans DERM al))
Brand Name: Emsam

What is selegiline transdermal?

Selegiline prevents the breakdown of chemicals in the brain that are often imbalanced in people with depression.

Selegiline transdermal is used to treat major depressive disorder in adults.

Selegiline may also be used for purposes not listed in this medication guide.

What is the most important information I should know about selegiline transdermal?

You should not use this medication if you are allergic to selegiline, or if you have pheochromocytoma (tumor of the adrenal gland).

There are many other medicines that can cause serious medical problems if you take them while using selegiline. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

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If you need surgery, tell the surgeon ahead of time that you are using selegiline. You will need to stop using selegiline for at least 10 days before a planned surgery. Do not stop using selegiline without first talking to your doctor.

While using selegiline 9-mg or 12-mg patches, do not drink alcohol or eat foods that are high in tyramine, listed in the "What should I avoid while using selegiline?" section of this leaflet. Eating tyramine while you are using selegiline can raise your blood pressure to dangerous levels and cause life-threatening symptoms.

You may have thoughts about suicide when you first start using an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

What should I discuss with my health care provider before using selegiline transdermal?

You should not use this medication if you are allergic to selegiline, or if you have pheochromocytoma (tumor of the adrenal gland).

Do not use selegiline if you have taken any of the following drugs within the past 14 days:

  • bupropion (Wellbutrin, Zyban);

  • buspirone (BuSpar);

  • carbamazepine (Equetro, Tegretol) or oxcarbazepine (Trileptal);

  • cyclobenzaprine (Flexeril);

  • dextromethorphan (cough medicine);

  • meperidine (Demerol), methadone (Dolophine, Methadose), propoxyphene (Darvon, Darvocet), or tramadol (Ultram, Ultracet);

  • mirtazapine (Remeron);

  • diet pills, ADHD medications, or cold medicines that contain dextromethorphan, ephedrine, pseudoephedrine, or phenylephrine;

  • any type of antidepressant;

  • St. John's wort; or

  • other MAO inhibitors, such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Zelapar), or tranylcypromine (Parnate).

After you stop using selegiline, you must wait at least 14 days before taking any of the medications listed above. You must wait at least 5 weeks after stopping fluoxetine (Prozac) before you can start using selegiline transdermal.

To make sure you can safely take selegiline, tell your doctor if you have any of these other conditions:

  • heart disease, high or low blood pressure;

  • seizures or epilepsy; or

  • a personal or family history of bipolar disorder (manic depression) or suicide attempt.

You may have thoughts about suicide when you first start using an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

FDA pregnancy category C. It is not known whether selegiline will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

It is not known whether selegiline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use selegiline transdermal?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

For patients using 9-mg or 12-mg patches: While you are using selegiline and for 14 days after you stop, you must not eat foods high in tyramine (listed in the "What should I avoid?" section of this leaflet. Eating these foods while you are using selegiline 9-mg or 12-mg skin patches can raise your blood pressure to dangerous levels.

Foods that you MAY eat include:

  • fresh meat, poultry, or fish (including lunch meat, hot dogs, breakfast sausage, and cooked sliced ham);

  • any vegetables except broad bean pods (fava beans);

  • processed cheese, mozzarella, ricotta, cottage cheese;

  • pizza made with cheeses low in tyramine;

  • soy milk, yogurt; or

  • Brewer's or baker's yeast.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Before applying a skin patch, wash the skin with soap and water and dry completely. The patch can be worn on a dry, smooth, and hairless area of your back, upper arm, chest, or thigh. Do not apply the patch to a skin wound or irritated skin, or wear it under tight clothing. Never cut a skin patch into smaller pieces.

Remove the patch after 24 hours, taking care not to touch the sticky side with your fingers. Fold the patch in half so that it sticks together. Throw the used patch away where children and pets cannot reach it.

Wash your hands with soap and water after applying a patch, and after removing one.

If you need surgery, tell the surgeon ahead of time that you are using selegiline. You will need to stop using selegiline for at least 10 days before a planned surgery. Do not stop using selegiline without first talking to your doctor.

Use only one patch at a time. While you are wearing the patch, do not expose it to sunlight or other sources of heat such as a heating pad, electric blanket, hot tub, or sauna.

Store the skin patches at room temperature away from heat and moisture. Keep each patch in the foil pouch until you are ready to apply one.

What happens if I miss a dose?

Apply a skin patch as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra patches to make up the missed dose.

If a patch becomes loose, press it back in place. If a patch falls off, apply a new one and go back to your regular schedule for patch changes.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe headache, hallucinations, vision problems, sweating, cool or clammy skin, fast or uneven heart rate, feeling lightheaded, fainting, or seizure.

What should I avoid while using selegiline transdermal?

While using the 9-mg or 12-mg patches, you must NOT eat foods that are high in tyramine, including:

  • air dried meats, aged or fermented meats, sausage or salami (including cacciatore and mortadella), pickled herring, and any spoiled or improperly stored beef, poultry, fish, or liver;

  • beer from a tap, beer that has not been pasteurized;

  • aged cheeses (such as blue, Swiss, cheddar, Parmesan, or Romano cheese);

  • over-the-counter supplements or cough and cold medicines that contain tyramine;

  • sauerkraut, soy beans, soy sauce, tofu, fava beans; or

  • yeast extracts (such as Marmite).

Eating tyramine while you are using selegiline can raise your blood pressure to dangerous levels which could cause life-threatening side effects. You should become very familiar with the list of foods to avoid while you are using selegiline.

Avoid drinking alcohol while you are using selegiline.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Selegiline transdermal side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Remove the skin patch and get emergency medical help if you have any of these signs of dangerously high blood pressure:

  • sudden and severe headache, blurred vision, buzzing in your ears, anxiety, confusion;

  • sweating, nausea, neck stiffness, chest pain, feeling short of breath; or

  • fast or pounding heartbeats, fluttering in your chest.

Call your doctor at once if you have a serious side effect such as:

  • pain or burning when you urinate;

  • swelling in your hands or feet; or

  • problems with speech or balance, seizure (convulsions), sudden numbness or weakness (especially on one side of the body).

Less serious side effects may include:

  • redness or itching where the patch is worn;

  • mild headache, muscle pain;

  • diarrhea, constipation, upset stomach, dry mouth;

  • sleep problems (insomnia);

  • mild bruising, itching or rash; or

  • cough, sore throat, sinus pain or stuffy nose.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Selegiline dosing information

Usual Adult Dose for Parkinson's Disease:

Adjunct to levodopa/carbidopa:

Oral tablet: 5 mg twice a day at breakfast and lunch.

Oral disintegrating tablet: 1.25 mg once a day, before breakfast, for at least 6 weeks. After 6 weeks, the dose may be increased to 2.5 mg once a day if needed.

Usual Adult Dose for Depression:

Major Depressive Disorder:

Initial: Apply one transdermal patch (6 mg/24 hours) to intact skin once every 24 hours.
Maintenance: 6 mg/24 hours up to a maximum of 12 mg/24 hours.

What other drugs will affect selegiline transdermal?

There are many other medicines that can cause serious medical problems if you take them while using selegiline. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about selegiline transdermal.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.01. Revision Date: 2012-04-15, 9:46:24 PM.

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