Drugs & Vitamins

Selegiline skin patches Active Ingredients: Selegiline skin patches Representative Names: Emsam Available Product Images: What are Selegiline skin patches? What should I tell my health care provider before I take this medicine? How should this medicine be used? What if I miss a dose? What drug(s) may interact with Selegiline, Transdermal? What side effects may I notice from receiving Selegiline, Transdermal? What should I watch for while taking Selegiline, Transdermal? Where can I keep my medicine? What are Selegiline skin patches? (Back to top) SELEGILINE TRANSDERMAL (Emsam®) is a medicine used for the treatment of depression. It is applied as a patch to your skin. You may have to use this medicine for 1 to 4 weeks or longer before you begin to feel better. A patient medication guide about using antidepressants in children and teenagers is available for this medicine, although it is not typically used in children. You may receive a copy of this medication guide from your Pharmacist. Read it and discuss the contents with your health care provider. Generic Selegiline Transdermal skin patches are not yet available. What should I tell my health care provider before I take this medicine? (Back to top) They need to know if you have any of these conditions: •alcoholism or frequent alcohol intoxication •dementia •heart disease or high blood pressure •low blood pressure, a feeling of faintness upon standing or orthostatic hypotension •mental disorder, like bipolar disorder, mania, depression, psychosis or a past history of a suicide attempt •pheochromocytoma •upcoming surgery or medical procedure •an unusual reaction to oral selegiline, transdermal selegiline, other medicines, foods, dyes, or preservatives •pregnant or trying to get pregnant •breast-feeding How should this medicine be used? (Back to top) This medicine is for use on the skin. Carefully follow the directions that come with the patches. Use exactly as directed. Find an area of skin on your upper torso (below the neck and above the waist), upper thigh, or the outer surface of the upper arm that is clean, dry, undamaged, and hairless. Before you apply the patch wash hands and the area where the patch is to be applied with soap and water . Dry your hands and the area thoroughly. Remove the patch from the sealed pouch and apply it immediately. Do not try to cut or trim the patch. Using your palm, press the patch firmly in place to make sure that there is good contact with your skin. Wash your hands again with soap and water after you apply the patch. Change the patch every day, at roughly the same time each day. When you apply a new patch, use a new area of skin. Do not use more than one patch at a time. If your patch falls off, apply a new patch to a new site and continue with your previous schedule. You should throw away the folded patch so that children and/or pets cannot reach it. Showering, bathing, or swimming should not effect your patch. Avoid having the patch come in contact with sources of heat like heating pads, electric blankets, heat lamps, saunas, hot tubs, heated water beds, and prolonged direct sunlight. Elderly patients over age 65 years may have a stronger reaction to this medicine and should use it with caution. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. What if I miss a dose? (Back to top) If you forget to replace a patch, use it as soon as you can. Only use one patch at a time and do not leave on the skin for longer than directed. If a patch falls off, you can replace it, but keep to your previous schedule and remove the patch at the right time. What drug(s) may interact with Selegiline, Transdermal? (Back to top) Selegiline skin patches have the potential to interact with many medications and foods. The list below contains some of the drugs that can interact: Do not use selegiline skin patches with any of the following medications: •alcohol-containing beverages or medications •amphetamine, dextroamphetamine, methamphetamine, dexmethylphenidate, methylphenidate (Ritalin®) and other stimulants (these are often used to treat attention deficit hyperactivity disorder or ADHD) •bupropion (for example Wellbutrin®, Zyban® or others) •buspirone (Buspar®) •carbamazepine (Tegretol®) •certain cold medications (prescription or over-the-counter) that have decongestants like pseudoephedrine (Sudafed® and others) or ephedrine •cocaine •cyclobenzaprine (Flexeril®) •dextromethorphan (Robitussin® and others) •furazolidone (Furoxone®) •general anesthetics •meperidine (Demerol®) •metaraminol •methadone •mirtazapine (Remeron®) •oxcarbazepine (Trileptal®) •oral selegiline (Eldepryl®) or other monoamine oxidase inhibitors (e.g., isocarboxazid, phenelzine, and tranylcypromine) and drugs with MAOI-like properties (e.g., furazolidone, linezolid, isoniazid, or procarbazine) •propoxyphene (Darvon®) •selective serotonin reuptake inhibitors (SSRIs); for example fluoxetine (Prozac®), sertraline (Zoloft®), paroxetine (Paxil®) •serotonin and norepinephrine reuptake inhibitors (SNRIs); for example venlafaxine (Effexor®) and duloxetine (Cymbalta®) •St. John's wort •selective norepinephrine reuptake inhibitors, like atomoxetine (Strattera®) •tramadol (Ultram®) •tricyclic antidepressants (TCAs); for example imipramine (Tofranil®) and amitriptyline (Elavil®) •tryptophan (see below for foods that contain tyramine), valerian, yohimbine, S-adenosyl-L-methionine (SAM-e) and possibly other herbal supplements Other medications that selegiline skin patches may interact with: •altretamine •caffeine (and certain products that may contain caffeine, such as guarana, green tea, colas and coffee) •kava kava, an herbal supplement •local anesthetics •opiate agonist (for example, codeine, hydrocodone, morphine) •pentazocine (Talwin®) •serotonin-receptor agonists, such as sumatriptan (Imitrex®) or zolmitriptan (Zomig®) Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines. What side effects may I notice from receiving Selegiline, Transdermal? (Back to top) Side effects that you should report to your prescriber or health care professional as soon as possible: •confusion or disorientation •fast heartbeat or a change in the way your heart beats (palpitations) •lightheadedness or fainting, especially if it leads to any falls •mania symptoms (like inability to sleep, restlessness, hyperactivity or other unusual behaviors) •onset of severe nausea or feeling sick to your stomach •rapid onset of sweating •severe headache •stiff neck •symptoms of serotonin syndrome (nausea, vomiting, sedation, dizziness, sweating, flushed face, confusion, restlessness, muscle spasm or twitching, shivering, and hypertension) •worsening depression Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome): •dry mouth •minor weight loss •skin rash, mild redness or itching in the area where you apply the patch and it does not go away within several hours after removing the patch •stomach problems, such as temporary diarrhea, heartburn or gas (flatulence) What should I watch for while taking Selegiline, Transdermal? (Back to top) Patients, their families and their caregivers should report to their health care provider the occurrence of anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment or when the dose is adjusted up or down. Families and caregivers of patients should be advised to observe for these symptoms on a day-to-day basis. Changes may occur quickly. Symptoms like these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly a change in the medication. You may get dizzy or drowsy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. If you feel dizzy while using this medicine, get up or change position very slowly to help avoid fainting. Alcohol can increase dizziness and drowsiness. Avoid alcoholic drinks. This medicine at the 9 mg/24 hr dose or the 12 mg/24 hr dose may interact with certain foods that have tyramine. It can cause severe headaches, a rise in blood pressure, or irregular heart beat. Foods that have significant amounts of tyramine include aged cheeses; meats and fish (especially aged, smoked, pickled, or processed, like bologna, pepperoni, salami, summer sausage); beer and ale; alcohol-free beer; wine (especially red); sherry; hard liquor; liqueurs; avocados; bananas; figs; raisins; soy sauce; miso soup; yeast/protein extracts; bean curd; fava or broad bean pods; or any over-ripe fruit. Also, avoid drinks that have caffeine, like tea, coffee, chocolate, or cola. Ask your prescriber or health care professional, pharmacist, or nutritionist for a complete listing of foods to be limited or avoided. Avoid these foods and beverages for 2 weeks after you stop using selegiline transdermal. You do not have to follow diet restrictions if you are using the selegiline 6 mg/24 hr patch. Do not apply more than one patch at a time. Do not cut the patch into smaller portions. You may get a dry mouth when using this medicine. To relieve your dry mouth, you may suck on hard candies (sugar-free if needed) or drink extra fluids. Where can I keep my medicine? (Back to top) Keep out of the reach of children in a container that small children cannot open. Store this medicine in a safe place where children and pets cannot reach it. When you remove a patch, fold with sticky sides together; put in an empty opened pouch and throw away. Throw away in a container where children, pets, and others cannot accidentally apply or ingest the used patch. Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Do not store outside of the sealed pouch that your patch originally came in. Last Updated:04/10/2006 CLINICAL PHARMACOLOGY© GOLD STANDARD MULTIMEDIA INC, ALL RIGHTS RESERVED

Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It should not be construed to indicate that the use of the product is safe, appropriate, or effective for you. Consult your healthcare professional before taking the product.