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Selegiline Transdermal System (EMSAM®): Basic Information

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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Disclaimer: The material on this website is provided as general education for medical professionals. It is not intended or recommended for patients or other laypersons or as a substitute for medical advice, diagnosis, or treatment. Patients must always consult a qualified healthcare professional regarding their diagnosis and treatment. Healthcare professionals should always check this website for the most recently updated information.

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