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Selegiline (transdermal)

Generically, selegiline (transdermal) se-LE-ji-leen Se-LE-ji-leen
The brand name is Emsam.
Form of dosage: transdermal film, extended release (12 mg/24 hours; 6 mg/24 hours; 9 mg/24 hours)
Drug classes: dopaminergic antiparkinsonism agents, monoamine oxidase inhibitors

What is Selegiline transdermal?

Selegiline stops the breakdown of certain chemicals in the brain, which tend to be imbalanced in patients who suffer from depression.

Selegiline transdermal can be used to treat major depression in adolescents and adults who are 12 years old.Selegiline can also be used for reasons not mentioned in this guideline for medication.

Side effects of Selegiline transdermal

See a doctor immediately. If you are experiencing symptoms that indicate an allergic reaction,face, suchives,ives; difficulty breathing, and swelling of your lips, face and throat,symptoms,Inform your doctor about any new or worsening symptoms to your physician for example, mood or changes in behavior, anxiety, panic attacks,depressed, or trouble sleeping, or if you are feeling uncontrollably angry, irritable and aggressive, anxious, or hyperactive (mentally and physically) or depressed or if you are thinking about suicide or harming yourself.

Take off the patch of skin and seek medical attention immediately. If you notice any of the following symptoms of dangerously elevated blood pressure: sudden and intense headache or confusion, vision issues, chest pains or pain in your ears or neck, sweating, vomiting,and neck stiffness, rapid or slow heartbeats or pupils that are dilated.

Selegiline can cause severe adverse effects. Consult your doctor immediately in the event of:

  • Suddenly numbness or weakening (especially on either side);
  • Issues with balance or speech;
  • Manic episodes: racing thoughts, increased energy, unusual risk-taking, extreme happiness, becoming uneasy or agitated

Take off your patch from the skin and get medical treatment right away if you experience symptoms of serotonin syndrome like agitation, hallucinations or fever, sweating or shivering, a rapid heart rate, muscle stiffness, losing coordination, twitching, nausea, vomiting, or diarrhea.

Common adverse effects of selegiline could include:

  • Redness and itching in the area where the patch is worn
  • Headache;
  • Diarrhea, an upset stomach, a dry mouth
  • Sleep problems (insomnia);
  • Rashes
  • Nasal pain or nasal congestion.

This isn't an exhaustive list of all the side effects. Other side effects could occur. Contact your doctor to seek medical advice on adverse effects. You can report any symptoms to the FDA at 1-800-FDA-1088.


Selegiline should not be used when you suffer from adrenal gland cancer or in the case of other medications. Numerous drugs may interfere with selegiline, and some medications should not be combined.

Some young people might be thinking about suicide after the first time they took an antidepressant. Keep vigilant for changes in your mood or signs. Inform your doctor if you notice any changes or worsening symptoms.

Prior to use this drug

Selegiline is not a good choice when you have an allergy to it or you suffer from pheochromocytoma (a tumor in the adrenal gland).

Certain medicines may cause unintentional or hazardous consequences when combined with selegiline. Your doctor may have to alter the treatment regimen if you've taken any of these medications in the last two to five weeks:

  • Carbamazepine;
  • Dextromethorphan (cough medicine);
  • Meperidine, methadone, pentazocine, or tramadol;
  • Certain antidepressants—citalopram, clomipramine, desvenlafaxine, duloxetine, fluoxetine, imipramine, milnacipran, paroxetine, sertraline, venlafaxine, Cymbalta, Effexor, Savella, Pristiq, Prozac, Zoloft, and others.

To make sure that selegiline is suitable for you, ask your doctor if you have ever experienced:

  • Heart disease, high blood pressure;
  • Seizures or epilepsy;
  • Bipolar disorder (manic depression) or suicide attempt

Many young people are prone to thoughts of suicide while first starting an antidepressant. Your doctor should monitor your progress regularly. Family members or other caregivers should be aware of changes in your symptoms or mood.

It isn't known if selegiline is harmful to an unborn child. It is possible that you will experience a relapse of depression when you stop taking your antidepressant. Inform your doctor immediately if you are pregnant. Do not take or stop taking selegiline while pregnant without the advice of your doctor.

It isn't known if selegiline gets into breast milk or whether it can harm the baby who is nursing. Do not breastfeed during treatment with this medication for a minimum of five days after the last dose.Selegiline transdermal isn't permitted for use by anyone who is younger than 12 years old.

How to take Selegiline transdermally?

Follow the instructions on the prescription label. The doctor may modify your dose. Avoid using this medicine in smaller or larger quantities or for longer periods than the recommended time.Take note of all patient information, such as medication guides and instruction sheets you are given. Talk to your pharmacist or doctor for any additional questions.

Apply the patch to clean, dry, and hairless skin on your back, chest, thigh, or upper portion of your arm. The patch should be firmly pressed to secure it. It is possible to leave the patch in place while showering, bathing, or even swimming. Take off the patch of skin within 24 hours, then replace it with a brand new one. Pick a different area in your body where you can put the patch every time you wear the new patch.

Cleanse your hands using soap and water after putting on the patch and after you have removed one.If the patch gets ripped off, then try to stick it back in place. If it isn't sticking well, you can put on another patch and keep it on for the remainder of the wear time. Don't alter your schedule for removing patches.

Wear only one patch of selegiline at a time. Using extra skin patches won't make the medication more efficient. Don't cut your skin patch. When wearing the patch, don't expose it to direct sunlight or any other sources of heat, such as a heated blanket, hot tub, or sauna.

If you require surgery, inform the surgeon in advance that you're taking selegiline prior to surgery. It is possible that you will need to stop using the medication for a minimum of 10 days prior to the scheduled surgery. Don't stop taking selegiline until you have spoken with your physician.Keep the patches of skin at room temperature, away from humidity and heat. Place each patch in the aluminum pouch until you're ready to put on the patch.

Make sure to keep both unused and used skin patches made of selegiline out of the reach of children and pets. Selegiline contained in the skin patch that has been used could be fatal for pets or children if a pet has a mishap and chews the patch. Get medical attention immediately when this occurs.

Details on dosage

Usual Adult Dose for Parkinson's Disease:

Tablets and capsules for oral consumption: 5 mg, taken daily, taken orally in the morning and lunch
Maximum dosage daily: 10 mg oral per day
Tablets that dissolve in the mouth:
Initial dosage: 1.25 mg orally once per day for a minimum of 6 weeks
After six weeks, the dosage could increase to 2.5 mg once a day if necessary.
Dosage for maintenance: 1.25 to 2.5 mg daily, orally before breakfast.
Maximum dosage: 2.5 mg orally once every day.
Within 2 to 3 days of the first day of treatment with this drug, it is possible to decrease the dosage, which is levodopa and carbidopa. Usually, a 10–30% reduction is required, and further reductions are feasible during the continued use of the drug.
There is no evidence that this drug has beneficial effects in the absence of simultaneous levodopa therapy.
Utilization: as an addition in the treatment of Parkinson's disease for patients treated with levodopa or carbidopa who show a decline in the quality of their responses to this treatment.

Usual Adult Dose for Depression:

Transdermal System:
Initial dosage: 6 mg/24-hour patch, applied topically every day.
Based on clinical judgment, dosages can be increased by increments of 3 mg/24 hours at intervals of not less than two weeks.
Maintenance dosage: 6 mg/24 hours up to 12 mg/24 hours patch, applied topically, once a day.
Maximum dose: 12 mg/24 hours
The full antidepressant effect could be delayed.
Foods that contain a high amount of tyramine should be avoided starting on day one of treatment at a dose of 9 mg/24 or 12 mg/24 hours and kept off for 2 weeks following the time these doses have been decreased to 6 mg/24 hours or less.
Treatment of major depression (MDD)

What happens if I miss the dose?

Apply a patch to your skin immediately after you recall. Don't miss your missed dose if it's nearing the time for the next dose scheduled. Don't use any extra patches to replace the dose that was missed.

What happens if I overdose?

Get medical attention immediately, or contact us for help at the Poison Help Line at 1-800-222-1222. Overdose symptoms can develop for up to 12 hours following the overdose and may become worse in the following 24 to 48 hours.

Overdose symptoms can include severe headache hallucinations, the feeling of fever, hot or dry skin, a fast or irregular heartbeat, and breathing problems, as well as feeling uneasy or anxious muscles, twisting movements, and unusual arching in your neck or back, fainting, or a seizure.

What should be avoided?

Beware of drinking alcohol while you're using selegiline.

While you are using the 9 mg or 12-mg patches, and up to 14 days following your cessation of eating, you are not allowed to consume foods high in tyramine. This includes:

  • Air-dried meats such as aged or fermented meats such as salami or sausage (including mortadella and cacciatore) and pickled herring and any spoilt or improperly stored poultry, beef fish, liver, or;
  • Tap water or tap that has not been pasteurized;
  • Aged cheeses that have been aged (such as blue Swiss cheese, cheddar Parmesan, and Romano cheese);
  • Over-the-counter medicines for cough and cold medications that contain tyramine
  • Sauerkraut, soy beans, soy sauce, tofu, fava beans,
  • The yeast extracts (such as Marmite).

Tyramine consumption while taking selegiline could increase your blood pressure to levels that could result in life-threatening adverse effects. It is important to be acquainted with what foods you should not eat while you're using selegiline (9 mg) or patches of 12 mg.

Selegiline can impair your ability to think or react. Be aware if you are driving or doing any other activity that requires you to stay vigilant.

Interaction with other drugs

If you've taken fluoxetine (Prozac, Sarafem) and you want to discontinue it for five weeks prior to beginning using selegiline transdermal,

Certain drugs may be incompatible with selegiline, and certain medications should not be combined. Discuss with your doctor all the medications you are currently taking and all the ones you begin or stop taking, particularly:

  • Buspirone (buspar);
  • Any other antidepressant,
  • Cough or cold medication that has a decongestant in it, like phenylephrine and pseudoephedrine;
  • Prescription or over-the-counter diet pills;
  • A dietary or herbal supplement containing tyramine
  • Stimulant medications like Adderall as well as other medications to treat ADHD. Other stimulant medicines include Adderall or other medications to treat ADHD.

This isn't a complete list, and other drugs may affect selegiline. This includes over-the-counter and prescription medications, vitamins, and herbal remedies. There are not all the interactions mentioned in this medication guide.

When you stop taking selegiline, it is possible that you will require a wait of at least two weeks before starting to use other drugs.



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