Emsam Patch: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Emsam Patch contains selegiline, a monoamine oxidase inhibitor (MAOI), delivered through the skin. It is used to treat Major Depressive Disorder (MDD) in adults. It is applied once daily to the upper torso, upper thigh, or outer upper arm, and the recommended adult dose is 6 mg per day. As an MAOI, it carries specific warnings around diet, heat exposure, and interactions with other medicines.

What is Emsam Patch

Emsam is a prescription patch that delivers the medicine selegiline through your skin. It is used to treat Major Depressive Disorder (MDD) in adults. It belongs to a group of medicines called monoamine oxidase inhibitors (MAOIs).

Emsam Patch uses

• Treats major depressive disorder.
• Helps reduce persistent sadness.
• Helps manage loss of interest in daily activities.
• May improve mood and emotional well-being.
• Helps manage depression when prescribed by a healthcare professional.

Benefits of Emsam Patch

• Avoids swallowing issues since it is a skin patch instead of a pill
• Has minimal gastrointestinal side effects compared to many oral antidepressants
• Provides steady, gradual absorption over 24 hours instead of sharp peaks
• Lower reported rates of triggering manic or hypomanic episodes compared to other antidepressant classes
• At the 6 mg dose, no special diet is required

How Emsam Patch works

Emsam blocks an enzyme called monoamine oxidase, which normally breaks down certain brain chemicals. By blocking this enzyme, the medicine raises the levels of brain chemicals like serotonin, norepinephrine, and dopamine, which is thought to improve mood.

Emsam Patch dosage

Apply the patch 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. Do not apply the patch near your waist, since clothing and movement may cause it to rub off. Choose a new application site each time you change your patch; do not use the same site two days in a row.

Wash the chosen skin area with soap and warm water and dry it thoroughly before applying the patch. Avoid applying the patch to skin that has powder, oil, lotion, cuts, irritation, or is hairy, scarred, or calloused. Apply the patch right after removing it from its sealed pouch.

Use only one patch at a time and do not cut the patch into smaller pieces. Change your patch one time each day at the same time each day. Press the entire patch firmly into place and rub the edges to make sure it sticks well. Wash your hands with soap and water after applying the patch, and avoid touching your eyes until you have washed your hands.

If the patch becomes loose, press it back in place; if it falls off completely, apply a new patch to a new site and continue your normal schedule. If you forget to change your patch after 24 hours, remove the old one and put a new patch on a different area, then continue your normal schedule.

Avoid exposing the patch site to direct heat sources such as heating pads, electric blankets, heat lamps, saunas, hot tubs, heated water beds, and prolonged direct sunlight. For elderly patients (65 years and older), the recommended dose is the lowest strength patch.

Available forms and strengths

• Transdermal patch (skin patch)

Side effects of Emsam Patch

Common

• Skin reaction where the patch is placed
• Headache
• Trouble sleeping (insomnia)
• Diarrhea
• Dry mouth
• Indigestion/upset stomach
• Rash
• Sore throat
• Sinus infection

Serious

• Suicidal thoughts or actions, especially in children, teenagers, and young adults
• Serotonin syndrome (a potentially life-threatening reaction)
• Sudden, severe increase in blood pressure (hypertensive crisis)
• Mania or hypomania (manic episodes), especially in people with a history of mania or bipolar disorder
• Severe allergic reactions including trouble breathing and swelling of the face, lips, mouth, tongue, or throat

Warnings and precautions

• Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults, especially within the first few months of treatment.
• This medicine should not be used in children under 12 years of age because it may cause a severe increase in blood pressure in this age group.
• Using this medicine with certain other antidepressants or certain pain, cold, and cough medicines can cause a potentially life-threatening problem called serotonin syndrome.
• You must avoid foods and drinks high in tyramine while using the two higher-strength patches, and for two weeks after stopping them, because this combination can cause a sudden, dangerous rise in blood pressure.
• Avoid exposing the patch to direct heat sources, since heat may cause too much medicine to be absorbed into your body.
• This medicine should be used cautiously in people with a history of mania, as it can rarely trigger a manic or hypomanic episode.
• It is not known if Emsam will harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant so you can discuss the risks and benefits together.
• It is not known if Emsam passes into breast milk. Talk to your healthcare provider about the best way to feed your baby if you are using this medicine.
• No dose adjustment is needed for people with mild, moderate, or severe kidney impairment, based on study data. This medicine has not been studied in patients with end-stage kidney disease or those needing dialysis.
• No dose adjustment is needed for people with mild or moderate liver impairment. This medicine has not been studied in people with severe liver impairment.
• You should not drink alcohol while using this medicine.
• Do not drive, operate heavy machinery, or do other dangerous activities until you know how this medicine affects you.

Storage

• Store EMSAM at room temperature between 68°F to 77°F (20°C to 25°C)
• Store EMSAM in the sealed pouch it comes in until you are ready to use it
• Keep EMSAM and all medicines out of the reach of children
• Fold the used patch in half and press it together firmly so the sticky side sticks to itself
• Safely throw away the folded patch in a container with a lid right away so children and pets cannot reach it
• Safely throw away any unused patches left over from the prescription as soon as they are no longer needed

When to see a doctor

• Call your healthcare provider right away if you have thoughts about suicide or dying, attempts to harm yourself, new or worse depression or anxiety, feeling agitated, restless, angry or irritable, panic attacks, trouble sleeping, acting aggressive or violent, acting on dangerous impulses, or an extreme increase in activity or talking.
• Go to the nearest hospital emergency room right away if you suddenly develop symptoms of serotonin syndrome, such as agitation, hallucinations, confusion, coma, rapid pulse, low blood pressure, dizziness, sweating, flushing, fever, seizures, tremors, stiff muscles, muscle twitching, nausea, vomiting, or diarrhea.
• Go to the nearest hospital emergency room right away if you suddenly have symptoms of a hypertensive crisis (dangerously high blood pressure), such as sudden severe headache, nausea, vomiting, stiff or sore neck, fast or irregular heartbeat, excessive sweating, enlarged pupils, light sensitivity, or chest pain with a fast or slow heartbeat.
• If you have symptoms of an overdose, remove your patch right away and call your healthcare provider or go to the nearest hospital emergency room right away.

Alternatives

• Isocarboxazid
• Tranylcypromine
• Phenelzine