Selegiline is an irreversible inhibitor of monoamine oxidase (MAO). Here is key information about its transdermal formulation, the selegiline transdermal system (EMSAM®).
FDA-approved indications
Major depressive disorder (MDD)
Dosage
Starting dose and target dose: 6 mg/24 hrs.
Based on clinical judgment, dose increases should occur in increments of 3 mg per 24 hours (up to a maximum dose of 12 mg per 24 hours) at intervals of no less than 2 weeks.
Geriatric Use: The recommended dose for elderly patients (65 years and older) is EMSAM® 6 mg per 24 hours daily.
Dietary Modifications
With EMSAM® 9 mg per 24 hours and 12 mg per 24 hours:
Tyramine-rich foods and beverages should be avoided beginning on the first day of EMSAM® 9 mg/24 hours or 12 mg/24 hours treatment, and should continue to be avoided for 2 weeks after a dose reduction to EMSAM® 6 mg per 24 hours or following the discontinuation of EMSAM® 9 mg per 24 hours or 12 mg per 24 hours.
General Instructions
1. Apply to dry, intact skin on the upper torso (below the neck and above the waist), upper thigh or the outer surface of the upper arm once every 24 hours
2. Dose increases should occur in increments of 3 mg per 24 hours (up to a maximum dose of 12 mg per 24 hours) at intervals of no less than 2 weeks
Dosage forms and strengths
Transdermal System: 6 mg/24 hours, 9 mg/24 hours and 12 mg/24 hours
Please refer to Prescribing Information (see link below) for a complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Related Pages
Classic MAO inhibitors—General articles
Types of MAO and of MAO inhibitors
Are MAO inhibitors (MAOIs) efficacious and safe for bipolar depression?
Combining an MAO inhibitor and another antidepressant
Can antidepressants be used with MAO-B inhibitors?
How to manage major depressive disorder with atypical features
Phenelzine
Phenelzine (Nardil®): Basic Information
How to choose between phenelzine (Nardil®) and tranylcypromine (Parnate®)
Selegiline
Selegiline Transdermal System (Emsam®): Basic Information
Tranylcypromine
Tranylcypromine (Parnate®): Basic Information
How to choose between phenelzine (Nardil®) and tranylcypromine (Parnate®)
Isocarboxazid
Isocarboxazid (Marplan®): Basic Information
MAO inhibitors—Drug interactions
MAO inhibitors and other medications
MAO Inhibitors and other medications (patient handout) (link to the handouts page)
Be very careful when switching from one MAO inhibitor to another
MAO inhibitors (MAOIs) and contraindicated medications: How long do we have to wait?
How to switch from oral or transdermal selegiline (Emsam®) to another MAO inhibitor
Should we prescribe emergency medication for hypertensive urgency with MAO inhibitors?
References
EMSAM® Prescribing Information
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