Selegiline (se-LE-ji-leen)

Treats depression. This medicine is an MAOI.

Brand Name(s):

Emsam

When This Medicine Should Not Be Used:

How to Use This Medicine:

Patch

• 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. It is usually applied to dry, intact skin of the upper back, upper chest, upper thigh, or on the outer surface of the upper arm.
• 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 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. Only one patch should be worn at a time.
• Do not put the patch over burns, cuts, or irritated skin. Avoid putting the patch on areas where the skin is hairy, oily, scared, or calloused, or where it could be rubbed off by tight clothing. After you apply the patch, press it down with your fingers and the palm of your hand to make sure it sticks to your skin.
• Put on a new patch if the old one has fallen off and cannot be reapplied.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: 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.
• Store the patches at room temperature in a closed container, away from heat, moisture, and direct light. Do not store this medicine outside of its sealed pouch.
• 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.

• You must avoid many other medicines while you are using selegiline. These medicines used together could cause serious health problems, including death. Ask your doctor before you use any other medicine. You may need to wait 1 to 5 weeks before you can use other medicines.
• Do not use selegiline if you have used an MAO inhibitor within the past 14 days. Do not use this medicine if you are also using medicine to treat depression (including an SSRI, SNRI, or TCA), narcotic pain medicine (including meperidine, tramadol, or methadone), dextromethorphan, or carbamazepine. This is not a complete list.
• Other medicines can affect how selegiline works. Tell your doctor if you are also using buspirone or cough or cold medicine (including pseudoephedrine, phenylephrine, or phenylpropanolamine).
• Avoid foods and drinks that are high in tyramine, because your blood pressure could get dangerously high. Your doctor should give you a complete list. In general, do not eat anything aged or fermented, such as most cheese, most alcohol, cured meat (such as salami), sauerkraut, and soy sauce. Check the expiration dates on packages. Tyramine levels get higher as food gets older or if it has not been refrigerated properly.
• Do not drink alcohol while you are using this medicine. Also limit how much caffeine you eat or drink.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant, or if you have high blood pressure, heart disease, or a history of seizures, bipolar disorder, or mania.
• Do not breastfeed during treatment with this medicine and for 5 days after your last dose.
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may cause the following problems:
  • Extremely high blood pressure, which could be life-threatening
  • Serotonin syndrome (when used with other medicines)
• Do not let the patch get too hot. Avoid direct sunlight. Do not use an electric blanket or heating pad, heat lamp, sauna, hot tub, or a heated water bed while you are wearing it.
• 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. Also, this medicine may interact with the dye used during some medical tests.
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you feel lightheaded.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

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
• Anxiety, restlessness, fever, sweating, nausea, vomiting, diarrhea, seeing or hearing things that are not there
• Feeling more excited or energetic than usual, trouble sleeping
• Frequent or severe headache, fast or pounding heartbeat
• Lightheadedness, dizziness, or fainting
• Stiff neck, nausea, vomiting, sweating, light sensitivity
• Unusual behavior, thoughts of hurting yourself or others

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

• Itching, redness, or swelling where you wear the patch

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