Drug Name:
EMSAM Rx
Generic Name and Formulations:
Selegiline 6mg/24hrs, 9mg/24hrs, 12mg/24hrs; transdermal system.
Company:
Mylan Specialty L.P.
Therapeutic Use:
Indications for EMSAM:
Major depressive disorder.
Adult:
Apply to dry, intact skin on upper torso, upper thigh, or outer surface of upper arm. Rotate application sites. Do not cut patches. ≥18yrs: initially one 6mg/24hrs patch once daily. May titrate at intervals of ≥2 weeks in increments of 3mg/24hrs; max 12mg/24hrs. Elderly (≥65yrs): 6mg/24hrs once daily. Doses above 6mg/24hrs: see full labeling for tyramine dietary modifications.
Children:
≤17yrs: not recommended.
Contraindications:
Concomitant SSRIs (eg, fluoxetine, sertraline, paroxetine), SNRIs (eg, venlafaxine, duloxetine), TCAs (eg, clomipramine, imipramine), opiates (eg, meperidine, tramadol, methadone, pentazocine, propoxyphene), dextromethorphan. Concomitant carbamazepine. Children <12yrs of age. Pheochromocytoma.
Boxed Warning:
Suicidal thoughts and behaviors.
Warnings/Precautions:
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults; monitor for clinical worsening or unusual changes. Monitor for serotonin syndrome or hypertensive crisis; discontinue if occurs. History of bipolar disorder, mania/hypomania. Severe hepatic impairment, ESRD, dialysis: not studied. Avoid exposing patch to external heat sources. Reevaluate periodically. Elderly. Pregnancy. Nursing mothers: not recommended (during and for 5 days after the last dose).
Pharmacological Class:
MAOI.
Interactions:
See Contraindications. To avoid potentially severe or fatal interactions, allow sufficient drug-free interval between selegiline and contraindicated drugs (see full labeling). Increased risk of serotonin syndrome with concomitant other serotonergic drugs. Hypertensive crisis with carbamazepine. Monitor BP with concomitant buspirone, amphetamines, cold products or weight-reducing preparations with sympathomimetic amines (eg, pseudoephedrine, phenylephrine, phenylpropanolamine, ephedrine). Avoid alcohol, dietary supplements with tyramine.
Adverse Reactions:
Application site reaction, headache, insomnia, diarrhea, dry mouth, dyspepsia, rash, pharyngitis, sinusitis; serotonin syndrome, hypertensive crisis.
Generic Availability:
NO
How Supplied:
Transdermal system—30
Clinical Pain Advisor Articles
- MRS May Accurately Identify Painful Disks in Chronic Low Back Pain
- Examining the Relationships Among Opioid Use, Overdose, and Suicide
- Multispecies Probiotics May Be Effective in Chronic, Episodic Migraine
- Migraine Symptoms Can Improve Despite Unchanged Pain Avoidance, Endurance
- Mindfulness-Based Stress Reduction Also Benefits Chronic Pain
- MRS May Accurately Identify Painful Disks in Chronic Low Back Pain
- Does Opioid Tapering in Chronic Pain Result in Controlled Pain at Taper Completion?
- Spinal Cord Stimulation Shows Long-Term Effectiveness for Refractory Neuropathic Pain
- Color Doppler Ultrasound for the Diagnosis of Sacroiliitis in Inflammatory Back Pain
- An Evidence-Based Road Map to Navigating the Opioid Epidemic
- Generalized Mechanical Hyperalgesia in Chronic Migraine, Temporomandibular Disorder
- World Health Organization: Five-Year Plan to Address 10 Biggest Global Health Threats
- Physician-Mothers as Caregivers Increases Risk for Burnout, Mood Disorders
- Endothelial Dysfunction Biomarkers Elevated During Migraine Attacks in Women
- After Elbow Surgery, Children May Be Overprescribed Opioids
