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You need to be aware of what could happen when taking certain medications at the same time. Some medications are fine to take with EMSAM, but taking others may cause serious side effects.

Tell your health care professional all the medicines that you are taking or plan to take while on EMSAM. This includes both prescription and nonprescription medicines, such as vitamins and herbal supplements.

  • Tell ALL your health care professionals that you are using EMSAM
  • Your health care professional considers a number of factors when selecting a treatment for you. Do not stop or change your treatment with EMSAM, or take anything new, without talking with your health care professional first

Do not take the medicines in the chart below while using EMSAM and for 2 weeks after stopping EMSAM. Doing so could cause severe side effects that can be life-threatening. Click here for a downloadable reference.

Prescription medications you should NOT take with EMSAM

Other medications to treat depression (antidepressants)

Other monoamine oxidase inhibitors (MAOIs), including oral selegiline (eg. Eldepryl®)

BuSpar® (buspirone), an anxiety medicine

Pain medications containing meperidine (eg, Demerol®), tramadol (eg, Ultram®), methadone
(eg, Dolophine®), and propoxyphene (eg, Darvon®)

Flexeril® (cyclobenzaprine) or other medicines that contain cyclobenzaprine, a medicine used to treat muscle spasms

Tegretol® (carbamazepine), or other medicines that contain carbamazepine, a seizure medicine

Trileptal® (oxcarbazepine), or other medicines that contain oxcarbazepine, a seizure medicine

Medincines called amphetamines, also called stimulants or "uppers"

Medicines containing decongestants (pseudoephedrine, phenylephrine, phenylpropanolamine [PPA],
and/or ephedrine), or the cough suppressant dextromethorphan

Over-the-counter products you should NOT take with EMSAM

St. John's Wort, an herbal supplement

Any herbal or dietary supplement that contains tyramine

Diet pils or herbal weight-loss products containing ephedrine

Cold/cough medicines containing pseudoephedrine, phenylephrine, PPA, or dextromethorphan

Some of these medicines will have to be stopped for 1 week (or more) before you can start EMSAM. Again, be sure to discuss all medicines you are taking with your health care professional.

EMSAM® — INDICATION AND IMPORTANT SAFETY INFORMATION

EMSAM Transdermal System is a skin patch used to treat major depressive disorder.

What is the most important information I should know about EMSAM?

  • Antidepressants may increase suicidal thoughts or actions in children, teenagers and young adults
  • Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts or feelings. This is very important when an antidepressant is started or when the dose is changed
  • Call a healthcare provider right away to report any new or sudden changes in mood, behavior, thoughts, or feelings
  • EMSAM Transdermal System is not approved for use in patients under 18 years of age

Call a healthcare provider right away if you or someone you care for have any of the following symptoms, especially if they are new, worse, or worry you:

Thoughts about suicide or dying; attempts to commit suicide; new or worse depression, anxiety or irritability; feeling very agitated or restless; panic attacks; trouble sleeping; acting aggressive, being angry or violent; acting on dangerous impulses; an extreme increase in activity and talking; other unusual changes in behavior or mood.

  1. Do not eat or drink foods and beverages with high amounts of a substance called tyramine while on EMSAM 9 mg/24 hr or 12 mg/24 hr, and for 2 weeks after stopping these doses. Ask your healthcare professional or see the Medication Guide for a complete list of foods and drinks that must be avoided. EMSAM at any dose should not be used in children under 12 even when used with dietary modifications.
    • – Consuming tyramine-rich foods and beverages can lead to a sudden, large increase in blood pressure called “hypertensive crisis.” This is a serious medical condition that may be life-threatening. Seek immediate medical care if you experience any of these symptoms: sudden severe headache, nausea, stiff neck, vomiting, a fast or slow heartbeat or a change in the way your heart beats (palpitations), tight chest pain, a lot of sweating, confusion, dilated pupils, and sensitivity to light
  2. Tell your doctor about all medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Tell all of your healthcare professionals that you are using EMSAM.
    • • Due to the potential for serious and life-threatening side effects, do not use the following medicines while using EMSAM at any dose, and for 2 weeks after stopping EMSAM:
    • – Other medicines to treat depression (antidepressants) including other MAOI medicines; medicines which contain selegiline (such as Eldepryl®);  St. John’s Wort; narcotic pain medicines that contain meperidine e.g., Demerol®; pain medicines tramadol, methadone, or propoxyphene; medicines containing carbamazepine e.g., Tegretol® a seizure medicine and oxcarbazepine, e.g., Trileptal® a seizure medicine; cold / cough preparations, decongestants, over-the-counter diet pills or herbal weight-loss products containing pseudoephedrine, phenylephrine, phenylpropanolamine, dextromethorphan, or ephedrine; herbal or dietary supplements that contain tyramine; Flexeril® (cyclobenzaprine), a medicine used to treat muscle spasms; amphetamines (stimulants or “uppers”); and BuSpar® (buspirone), an anxiety medicine
    • Some of these medicines will have to be stopped for 1 week (or more) before you can start using EMSAM

What should I tell my doctor before starting EMSAM Transdermal System?

  • Tell your healthcare professional about any medical conditions, including if you:
    • – Have or had manic episodes (a mental condition that causes “high” moods)
    • – Have any heart problems
    • – Have or had seizures (convulsions or “fits”)
    • – Tend to get dizzy or faint
    • – Are planning to have surgery
    • – Are or intend to become pregnant
    • – Are breast-feeding

What are the possible side effects of EMSAM Transdermal System?

  • EMSAM may worsen your depression, give you suicidal thoughts, or cause unusual changes in behavior. Call your healthcare professional right away if you feel worse with EMSAM
  • EMSAM may cause mania or hypomania in people who have a history of mania
  • EMSAM may cause low blood pressure. Lie down if you feel dizzy, faint, or lightheaded and change positions gradually
  • The most common side effect of EMSAM is a skin irritation where the patch is placed. Other common side effects with EMSAM include: headache, difficulty sleeping, diarrhea, dry mouth

How should I use EMSAM Transdermal System?

  • Use EMSAM exactly as prescribed and do not stop or change treatment (even if you start to feel better) without talking to your health care professional
  • Use only one patch at a time and change the patch once a day (every 24 hours). If you use more than one EMSAM patch at a time, remove the patches right away and call your doctor or Poison Control at 1-800-222-1222

General advice about EMSAM Transdermal System

  • Avoid exposing the EMSAM application site to direct heat, such as heating pads, electric blankets, heat lamps, saunas, hot tubs, heated water beds, and prolonged direct sunlight
  • Do not drive or operate hazardous machinery until you know how EMSAM affects you as EMSAM can reduce your judgment, ability to think, or coordination. Avoid drinking alcohol while using EMSAM
  • Do not use EMSAM if you are allergic to anything in EMSAM. See the Medication Guide for a complete list of ingredients in EMSAM
  • If you have any questions about your health or medicines, talk to your healthcare professional

You are encouraged to report negative side effects of prescription drugs to the FDA.

Visit www.fda.gov/medwatch, or call 1-800-FDA-1088

Please see full Prescribing Information, including Boxed Warning and Medication Guide.