Monograph Details
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Central Nervous System
> Mood disorders
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EMSAM |
| Manufacturer |
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Bristol-Myers Squibb and Somerset Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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MAOI. |
| Generic Name |
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Selegiline 6mg/24hrs, 9mg/24hrs, 12mg/24hrs; transdermal patch. |
| Indications |
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Major depressive disorder. |
| Children |
Not recommended.
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| Adults |
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Initial: apply one 6mg/24hrs patch daily to dry, intact skin on upper torso, upper thigh, or outer surface of upper arm. May titrate at intervals of ≥2 weeks in increments of 3mg/24hrs; max 12mg/24hrs. Rotate application sites. Reevaluate periodically. Do not cut patches. |
| Contraindications |
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To avoid potentially severe or fatal interactions (hypertensive crisis and/or serotonin syndrome), allow sufficient drug-free interval (see literature) between selegiline and: fluoxetine, buspirone, SSRIs, serotonin/norepinephrine reuptake inhibitors, tricyclics, bupropion, meperidine, tramadol, methadone, propoxyphene, dextromethorphan, St. John's wort, mirtazapine, cyclobenzaprine, other MAOIs, carbamazepine, oxcarbazepine, amphetamines, other sympathomimetic amines (eg, pseudoephedrine), general anesthesia [esp for elective surgery], cocaine, local anesthetics containing sympathomimetic vasoconstrictors; others (see literature). Pheochromocytoma. |
| Precautions |
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Doses above 6mg/24hrs: see literature for tyramine dietary modifications. Avoid exposing patch to external heat sources. Mania/hypomania. Monitor for clinical worsening or suicidality. Recent MI. Unstable heart disease. Conditions that affect metabolism or hemodynamic response. Elderly (monitor BP). Pregnancy (Cat.C). Nursing mothers. |
| Interactions |
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See Contraindications. Avoid alcohol, dietary supplements with tyramine. |
| Adverse Reactions |
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Application site reaction, headache, insomnia, GI upset, dry mouth, rash, pharyngitis, sinusitis, orthostatic hypotension; others. |
| How Supplied |
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Patches—30 |
| Additional Resources |
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• Related Prescribing Note |
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