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Some Precautions and Warnings With the Selegiline Transdermal Patch

Some precautions and warnings with the selegiline transdermal patch to be aware of include:
  • The selegiline transdermal patch has several potentially lethal food and drug interactions. In order to take the selegiline transdermal patch safely, you must commit to avoiding many medications, including many non-prescription medications. During treatment with the selegiline transdermal patch, always check with your healthcare provider before taking any medications (see Drug Interactions With the Selegiline Transdermal Patch and Emsam Food Interactions for more information).
  • The selegiline transdermal patch can cause a hypertensive crisis, which is a life-threatening increase in blood pressure. Because of this, you should not take the selegiline transdermal patch if you have heart problems (including heart disease) or cerebrovascular disease (such as a history of a stroke, TIA, or any bleeding in the brain). This is important because increases in blood pressure can be especially dangerous if you have these conditions. For this same reason, you should also not take the selegiline transdermal patch if you already have high blood pressure. Tell your healthcare provider right away if you have symptoms of a hypertensive crisis, such as:


    • Headaches
    • Feelings of a rapidly or forcefully beating heart (palpitations)
    • A sore or stiff neck
    • Nausea or vomiting
    • Sweating, with a high fever (or sometimes with cold, clammy skin)
    • Sensitivity to light
    • A rapid heart rate (tachycardia) or a slow heart rate (bradycardia)
    • Chest pain or throat tightness
    • Dilated (wide open) pupils.


  • People taking the 6 mg selegiline transdermal patch each day do not need to follow a special diet. However, those taking high doses of the selegiline transdermal patch must follow a special diet to avoid dangerous food interactions that may lead to a hypertension crisis (see Emsam Food Interactions).


  • Children under the age of 12 years old should never take the selegiline transdermal patch under any circumstances. Even the smallest available dose is too high for such children, and dangerous side effects could occur.


  • Antidepressants (including the selegiline transdermal patch) may increase the risk of suicidal thoughts or behavior in children, teenagers, and adults (see Antidepressants and Suicide for more information). Therefore, if you notice any changes in symptoms or develop new symptoms during treatment with the selegiline transdermal patch, talk with your healthcare provider immediately. Some of these symptoms may include anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thoughts or behavior (see Emsam and Suicide for more information).
  • Before prescribing the selegiline transdermal patch for depression, your healthcare provider should make sure that you do not have bipolar disorder (instead of depression). Sometimes, the symptoms of bipolar disorder and depression are very similar, and the selegiline transdermal patch can cause problems in people with bipolar disorder.
  • Be sure to tell all of your healthcare providers (including dentists and surgeons) that you are taking the selegiline transdermal patch.
  • The selegiline transdermal patch should be used with caution in people who have had a recent heart attack or who have unstable heart disease.
  • Do not cut the selegiline transdermal patch. Doing so could result in an overdose, since more medication than usual will be released from the patch.
  • Be careful to avoid heating the selegiline transdermal patch, as this may cause more medication to be absorbed into your skin. This means you will need to avoid hot tubs, saunas, heating pads, tanning booths, and other sources of heat.
  • In addition to causing dangerously high blood pressure, the selegiline transdermal patch can also cause low blood pressure (hypotension). Let your healthcare provider know if you have symptoms of low blood pressure, such as lightheadedness, dizziness, or fainting.
  • People taking the selegiline transdermal patch should use caution when driving, operating heavy machinery, or performing other tasks that require concentration -- especially when first starting the selegiline transdermal patch or when switching dosages. This is because the selegiline transdermal patch may affect a person's mental or physical ability to perform these tasks. Make sure to understand how the selegiline transdermal patch affects you before performing any task that requires mental or physical concentration.
  • The selegiline transdermal patch is considered a pregnancy Category C medication. This means that the selegiline transdermal patch may not be safe to use during pregnancy. Talk with your healthcare provider about the risks and benefits of using the selegiline transdermal patch during pregnancy (see Emsam and Pregnancy for more information).
  • It is not known if the medication from the selegiline transdermal patch passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about what makes the most sense for your particular situation (see Emsam and Breastfeeding).
  • The elderly appear to be more sensitive to the selegiline transdermal patch, and certain side effects may be more dangerous in elderly people.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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