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Overview: Emsam is used to treat depression. It is believed to work by increasing the amount of natural chemicals in the brain. Common side effects include skin reaction where the patch is placed, headache, trouble sleeping, diarrhea, and dry mouth. Call your health care provider right away if you have trouble breathing, new or increased thoughts of suicide or death, sweating, fever, or flushing, sudden severe headache, very increased energy, or significant trouble sleeping.

Uses

What is Emsam used for?

Emsam (selegiline) is commonly used to treat depression.

Emsam may also be used for other conditions as determined by your health care provider.

Selegiline is also available in forms that are taken by mouth. See Selegiline (Eldepryl) for more information.

How does Emsam work (mechanism of action)?

Emsam belongs to a group of medicines called monoamine oxidase inhibitors (MAOI). It is believed to increase the amount of natural chemicals called norepinephrine, dopamine, and serotonin in the brain.

How is Emsam supplied (dosage forms)?

Brands and other names

  • Emsam

Dosage forms and strengths

  • 6 mg, 9 mg, 12 mg per day patch

How should I store Emsam?

Emsam should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Do not store the patch outside the sealed pouch.

Side Effects

What are the most common side effects of Emsam?

The most common side effects of Emsam are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Skin reaction where the patch is placed
  • Headache
  • Trouble sleeping
  • Diarrhea
  • Dry mouth
  • Upset stomach or indigestion
  • Rash
  • Sore throat
  • Sinus infection

There may be other side effects of Emsam that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Emsam?

While less common, the most serious side effects of Emsam are described below, along with what to do if they happen.

Severe Allergic Reactions. Emsam may cause allergic reactions, which can be serious. Stop using Emsam and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Suicidal Thoughts or Actions. Emsam or other antidepressants may increase the risk of suicidal thoughts or actions in a small number of children, teenagers, or young adults in the first few months of taking the medicine or when the dose is changed. Depression or other serious mental health conditions are the most important causes of suicidal thoughts or actions. If you or your child is about to harm themselves, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your health care provider right away if you have any of the following symptoms.

  • New or increased thoughts of suicide or death
  • Suicide attempt
  • New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior

Serotonin Syndrome. Serotonin syndrome is when there is too much of a chemical called serotonin in your body. Emsam can cause serotonin syndrome when it is used alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

  • Sweating, fever, or flushing
  • Confusion
  • Feeling agitated or restless
  • Seeing or hearing unusual things
  • Dizziness
  • Fast or racing heartbeat
  • Nausea, vomiting, or diarrhea
  • Muscle twitching, stiffness, or tremor
  • Seizures

Increased Blood Pressure (Hypertension). Emsam may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your health care provider if your blood pressure increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable but look out for any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Extremely Elevated Mood (Mania). People with bipolar disorder can have severe high and low moods. The first symptom of bipolar disorder may be depression. People with bipolar disorder who are treated with an antidepressant, such as Emsam, may have a higher risk of having mania or a manic episode. Call your doctor right away if you have any of the following symptoms of a manic episode.

  • Very increased energy
  • Significant trouble sleeping
  • Racing, fast-paced thoughts
  • Reckless behavior
  • Unusually grand ideas
  • Excessive happiness or irritability
  • Talking faster or more than normal

Warnings & Precautions

Who should not use Emsam?

Allergies to Ingredients. People who are allergic to any of the following should not use Emsam.

  • Selegiline
  • Emsam
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Emsam.

Patients Younger Than 12 Years. Emsam should not be used by children younger than 12 years of age because they are more likely to experience a dangerous increase in blood pressure while using Emsam compared to older people.

Adrenal Gland Tumor (Pheochromocytoma). Emsam should not be used if you have a rare adrenal gland tumor known as pheochromocytoma. People with this condition are more likely to experience a dangerous increase in blood pressure while using Emsam compared to others.

Drug Interactions. Emsam should not be used while you are using certain other medicines. Before using Emsam, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about Emsam before using it?

Do not use Emsam unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share Emsam with other people, even if they have the same condition as you. It may harm them.

Keep Emsam out of the reach of children.

Emsam patch should be applied to your upper arm, upper chest, upper back, or upper thigh on clean and dry skin free of the following.

  • Any powder, oil, or lotion
  • Any skin problems, including cuts, irritation, rash, swelling, and redness
  • Hair
  • Scar
  • Callus

Avoid applying Emsam patch to the same site 2 days in a row. Choose a different site every time you change your patch.

Do not cut the Emsam patch into smaller pieces. Do not wear more than 1 patch at a time.

When applying a patch, avoid touching the sticky side. If you accidentally touch the sticky side, wash your hands right away.

Avoid exposing the applied Emsam patch to a source of heat such as heating pads, heated blankets, saunas, hot tubs, and long exposure to sunlight. Heating a patch can increase the amount of medicine released from the patch and increase the risk of side effects.

What should I tell my health care provider before using Emsam?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Emsam is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • History of suicidal thoughts or depression
  • High blood pressure
  • History or family history of bipolar disorder or mania
  • Seizures or convulsions
  • Alcohol use

Pregnancy. It is not known if or how Emsam could affect pregnancy or harm a fetus. Tell your health care provider if you are or plan to become pregnant. Your health care provider will let you know if you should use Emsam while you are pregnant or trying to get pregnant. 

Breastfeeding. It is not known if Emsam passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use Emsam while breastfeeding.

How can I get more information about Emsam?

For more information about Emsam, you can visit the drugmaker's website at www.EMSAM.com or call them at 800-796-9526.

Interactions

Does Emsam interact with foods or drinks?

Emsam can make your body more sensitive to tyramine, a natural substance found in foods such as aged cheese, cured meats, pickled vegetables, certain fruits, and fermented alcoholic beverages such as beer or red wine. Consuming these foods or drinks while using Emsam may cause very high blood pressure. Depending on your dosage, you may need to avoid high-tyramine foods during treatment and for up to 2 weeks after stopping Emsam. 

Alcohol should be avoided while using Emsam. The impact of alcohol on your mental alertness and physical coordination may be increased if you drink alcohol while using Emsam. Certain alcoholic beverages, such as beer or red wine, may also contain large amounts of tyramine.

Does Emsam interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Emsam.

  • An opioid, such as meperidine, tramadol, methadone, and pentazocine within the past week, which is a medicine used for certain types of pain 
  • A selective serotonin reuptake inhibitor (SSRI) or a serotonin norepinephrine reuptake inhibitor (SNRI) within the past week, which is a medicine commonly used for anxiety and depression
  • A tricyclic antidepressant, such as clomipramine and imipramine within the past week, even if it is not used for depression
  • Dextromethorphan within the past week, which is a cough suppressant contained in many prescription and OTC products for cold and flu symptoms
  • Carbamazepine (Tegretol, Carbatrol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • Buspirone, which is a medicine commonly used to treat anxiety
  • Methylphenidate or amphetamines, which are medicines commonly used to treat ADHD
  • A decongestant such as pseudoephedrine, phenylephrine, and oxymetazoline, which is used to treat nasal congestion caused by cold or allergies 

This may not be a complete list of medicines that can interact with Emsam. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Emsam?

If you or someone else has used too much Emsam, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
 

What should I do if I miss a dose of Emsam?

If you forget to change your patch after 24 hours, remove the current patch and put on a new patch (in a different skin area). Afterwards, resume your normal patch changing schedule.