EMSAM Rx

Indications for EMSAM:

Major depressive disorder.

Adult Dose for EMSAM:

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.

Children's Dose for EMSAM:

Not recommended.

Pharmacological Class:

MAOI.

Contraindications:

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.

Warnings/Precautions:

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:

See Contraindications. Avoid alcohol, dietary supplements with tyramine.

Adverse Reactions:

Application site reaction, headache, insomnia, GI upset, dry mouth, rash, pharyngitis, sinusitis, orthostatic hypotension; others.

How Supplied:

Patches—30