Selegiline Patches

What is this medication?

SELEGILINE (se LE ji leen) treats depression. It works by balancing the levels of dopamine in your brain, a substance that helps regulate mood. It belongs to a group of medications called MAOIs.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): EMSAM

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Bipolar disorder
• High blood pressure
• If you often drink alcohol
• Liver disease
• Pheochromocytoma
• Skin conditions or sensitivity
• Suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
• An unusual or allergic reaction to selegiline, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is for external use only. Follow the directions on the prescription label. Remove the patch from the pouch by tearing at the notches on the sides of the pouch. Do not use scissors. Apply the patch to clean, dry, smooth skin on the upper back, upper chest, upper thigh, or to the outer part of the upper arm. Avoid applying to injured, irritated, calloused, or scarred areas. Use only 1 patch at a time. Do not cut or trim the patch. Ensure that the patch is flat against the skin. Be sure the edges are stuck to the skin surface. Remove the old patch before applying a new one. Each time you apply a new patch, use a new area of skin on the upper back, upper chest, upper thigh, or to the outer part of the upper arm. Do not apply to the exact same site. Do not use your medication more often than directed. Do not stop taking except on your care team's advice.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. This medication is not approved for use in children. Do not use in children under 12 years of age.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, apply it as soon as you can. If it is almost time for your next dose, apply only that dose. Do not apply double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Atomoxetine
• Carbamazepine
• Cyclobenzaprine
• Dextromethorphan
• MAOIs like Marplan, Nardil, and Parnate
• Medications for pain like meperidine, tramadol, methadone, pentazocine
• Most other medications for depression
• Other medications containing selegiline, like Eldepryl and Zelapar
• Rasagiline
• Safinamide
• Stimulant medications for attention disorders
• St. John's Wort
• Viloxazine

This medication may also interact with the following:

• Alcohol
• Buspirone
• Ephedrine
• Epinephrine or racepinephrine
• Medications for nasal congestion like phenylephrine, pseudoephedrine
• Norepinephrine
• Stimulant medications for weight loss or staying awake

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse. Because it may take several weeks to see the full effects of this medication, it is important to continue your treatment as prescribed by your care team. Do not stop taking except on your care team's advice. You may develop a severe reaction. Your care team will tell you how much medication to take.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your care team.

If your care team increases the dose of this medication to more than 6 mg a day, ask about possible interactions with foods that contain tyramine because this medication may interact with these foods to produce severe headaches, a rise in blood pressure, or irregular heart beat. Continue to avoid tyramine-rich foods or beverages for 2 weeks after your care team reduces your medication to the 6 mg a day dose, or after you stop the 9 mg or 12 mg a day dose. If you start and continue the 6 mg dose, you do not need to make any diet changes.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medication. Avoid alcoholic drinks.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy and drinking plenty of water may help. Contact your care team if the problem does not go away or is severe.

Do not treat yourself for coughs, colds, or allergies without asking your care team for advice. Do not take any medications for weight loss without advice either. Some ingredients in these products may increase possible side effects.

This medication may affect blood sugar levels. If you have diabetes, check with your care team before you change your diet or the dose of your diabetic medication.

If you are scheduled for any medical or dental procedure, tell your care team that you are taking this medication. This medication can interact with other medications used during surgery.

This medication patch is sensitive to certain body heat changes. If your skin gets too hot, more medication will come out of the patch. Call your care team if you get a fever. Do not take hot baths. Do not sunbathe. Do not use hot tubs, saunas, hairdryers, heating pads, electric blankets, heated waterbeds, or tanning lamps. Do not do exercise that increases your body temperature.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Severe increase in blood pressure—sudden, severe headache, nausea, vomiting, stiff neck, fast or irregular heartbeat
• Thoughts of suicide or self-harm, worsening mood, or feelings of depression

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Dizziness
• Drowsiness
• Dry mouth
• Headache
• Irritation at application site
• Nausea
• Trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep this medication in the protective pouch until you are ready to use it. Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

When you remove a used patch, fold with sticky sides together and put in an empty opened pouch. Immediately throw away in a container with a lid so that children and pets cannot reach it. Wash your hands.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.