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Selegiline (Absorbed through the skin)

Selegiline (se-LE-ji-leen)

Treats depression. This medicine is a monoamine oxidase (MAO) inhibitor.

Brand Name(s):

Emsam

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

You should not use this medicine if you have had an allergic reaction to selegiline, or if you are taking other medicines to treat depression (such as amitriptyline, bupropion, doxepin, duloxetine, fluoxetine, imipramine, mirtazapine, nortriptyline, paroxetine, sertraline, venlafaxine, Celexa®, Cymbalta®, Effexor®, Elavil®, Lexapro?, Paxil®, Prozac®, Tofranil®, Wellbutrin®, or Zoloft®), anxiety medicine (such as buspirone or BuSpar®), MAO inhibitors (MAOI) (such as Eldepryl®, Marplan®, Nardil®, or Parnate®), St. John's wort, or pain medicines (such as meperidine, methadone, propoxyphene, tramadol, Darvon®, Demerol®, Dolophine®, or Ultram®). Do not use this medicine if you are taking seizure medicines (such as carbamazepine, oxcarbazepine, Tegretol®, or Trileptal®), cough medicines (such as dextromethorphan or Benylin®), medicine to treat muscle spasms (such as cyclobenzaprine or Flexeril®), over-the-counter diet pills, herbal weight-loss products, or cold medicines (such as ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine, Neo-Synephrine®, Novafed®, or Sudafed®), any herbal or dietary supplement that contains tyramine, or medicines called amphetamines (also called stimulants or "uppers"). Do not use this medicine if you have pheochromocytoma (a tumor of the adrenal gland). Do not use this medicine if you take selegiline capsules or tablets. This medicine should not be used in children under 12 years of age.

How to Use This Medicine:

Patch

  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
  • Your doctor will tell you how many patches to use, where to apply them, and how often to apply them. Do not use more patches or apply them more often than your doctor tells you to.
  • Wash your hands with soap and water before and after applying a patch.
  • Wash the area of skin where you will apply the patch gently with soap and warm water. Rinse completely and dry with a clean dry towel.
  • Leave the patch in its sealed wrapper until you are ready to put it on. Tear the wrapper open carefully. NEVER CUT the wrapper or the patch with scissors. Do not use any patch that has been cut by accident.
  • The patient instructions will show the body areas where you can wear the patch. When putting on each new patch, choose a different place within these areas. Do not put the new patch on the same place you wore the last one. Be sure to remove the old patch before applying a new one.
  • Do not put the patch on areas of hairy or oily skin or where your clothing is tight.
  • Do not put the patch over burns, cuts, or irritated skin.
  • While you are wearing the patch, do not expose it to external sources of direct heat, such as heating pads or electric blankets, heat lamps, saunas, hot tubs, heated water beds, or prolonged direct sunlight.
  • Put on a new patch if the old one has fallen off and cannot be reapplied.

If a dose is missed:

  • If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.

How to Store and Dispose of This Medicine:

  • Store the patches at room temperature in a closed container, away from heat, moisture, and direct light.
  • Fold the used patch in half with the sticky sides together. Throw any used patch away so that children or pets cannot get to it. You will also need to throw away old patches after the expiration date has passed.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Certain foods and drinks can cause very high blood pressure in people who are using selegiline. The high blood pressure can also occur during the 2 weeks after stopping it. This is more common with aged, smoked, or fermented foods that are high in tyramine. Some foods you should not eat are air dried, aged, and fermented meats, sausages and salami, pickled herring, and any spoiled or improperly stored meat, poultry, fish, or animal livers. You should not eat broad bean pods, aged cheese, yeast, sauerkraut, soy sauce, or tofu. You should also not drink any beer. All of the foods that you eat must be fresh or properly frozen.
  • You must avoid many other medicines while you are using selegiline. Using these medicines together could cause serious problems, including death. The medicines include herbs, supplements, and medicines you can buy without a prescription (over-the-counter). Ask your doctor before you use any other medicine.
  • Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding, if you tend to get dizzy or faint, or if you have any heart problems, a recent heart attack, manic episodes (a mental condition that causes "high" moods), seizures, or a history of drug or alcohol addiction.
  • Your blood pressure might get too high while you are using this medicine. This may cause headaches, blurred vision, and other symptoms. You might need to keep track of your blood pressure between doctor appointments. If you think your blood pressure is getting too high, call your doctor right away.
  • For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor or your child's doctor right away if you or your child start to feel more depressed and have thoughts about hurting yourselves. Report any unusual thoughts or behaviors that trouble you or your child, especially if they are new or are getting worse quickly. Make sure the doctor knows if you or your child have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you or your child have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you, your child, or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.
  • Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests. Wait at least 10 days before having a surgery.
  • This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert. You may also feel lightheaded when getting up suddenly from a lying or sitting position, so stand up slowly.
  • Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Changes in behavior, or thoughts of hurting yourself or others.
  • Fast or pounding heartbeat.
  • Feeling nervous, restless, anxious, agitated, or excited for no reason.
  • Lightheadedness, dizziness, or fainting.
  • Severe headache.
  • Stiff or sore neck.
  • Trouble sleeping.

If you notice these less serious side effects, talk with your doctor:

  • Dry mouth.
  • Headache.
  • Itching, redness, or swelling where you wear the patch.
  • Nausea, vomiting, diarrhea, or stomach pain.
  • Skin rash.
  • Sore throat.
  • Trouble having sex.
  • Weight loss.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088


Last Updated: 8/4/2014


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