Publication types Review MeSH terms Similar precautions should be taken when patients are switched from one MAOI to another, although more rapid switches (from one to eight days) have been safely performed.44,45, The practice of avoiding the narcotic analgesic meperidine in patients receiving MAOIs is based on data from case reports with nonselective MAOIs4652 and from one case report with oral selegiline and meperidine (pethidine).51 For those patients receiving MAOIs, morphine is considered the narcotic analgesic of choice.5355 Notably, alternative therapeutics are available for other contraindicated medications (Table 2).56, Over-the-Counter Medications Not Contraindicated For Patients Using the Selegiline Transdermal System. Pychiatr Ann 2001;31:378384.57. This medicine is available only with your doctor's prescription. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Browne B, Linter S. Monoamine oxidase inhibitors and narcotic analgesics: A critical review of the implications for treatment. The American Society of Health-System Pharmacists, 4500 East-West Highway, Suite 900, Bethesda, Maryland. If you are using the 6 mg/24 hour patch, you may continue your normal diet. Selegiline skin patch is used to treat mental depression in adults. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm, American Society of Health-System Pharmacists, Inc. Disclaimer, U.S. Department of Health and Human Services. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). sharing sensitive information, make sure youre on a federal Do not expose the patch to direct sunlight for very long. You should not use this medicine if you or your child are taking carbamazepine (Tegretol), other medicines to treat depression (eg, clomipramine, duloxetine, fluoxetine, imipramine, paroxetine, sertraline, venlafaxine, Celexa, Cymbalta, Effexor, Lexapro, Paxil, Prozac, Zoloft), certain pain medicines (eg, meperidine, methadone, pentazocine, propoxyphene, tramadol, Darvon, Demerol, Dolophine, Ultram), or cough medicines (eg, dextromethorphan, Benylin). They may help if other treatments fail. Heisler MA, Guidry JR, Arnecke B. Serotonin syndrome induced by administration of venlafaxine and phenelzine. Do not put the patch over hairy, oily, irritated, broken, scarred, or calloused skin. Monoamine oxidase inhibitors: A new generation. Codd EE, Shank RP, Schupsky JJ, et al. An official website of the United States government. Alcohol may interfere with the effect of this medication. These antidepressants require diet restrictions and avoiding certain medications to prevent serious side effects. URL of this page: https://medlineplus.gov/druginfo/meds/a607003.html. The .gov means its official. Fiedorowicz JG, Swartz KL. Dietary modifications should also be followed for two weeks after a dose reduction to 6 mg/24 hours.26, No dose adjustment is necessary for patients with mild-to-moderate renal or hepatic impairment. This medication is not approved for use in children. Do not apply double or extra doses. CNS Spectr. Double-blind, placebo-controlled trial of the safety and efficacy of selegiline transdermal system without dietary restrictions in patients with major depressive disorder. The selegiline transdermal system was developed to deliver sustained selegiline blood concentrations sufficient to selectively inhibit MAO-A and MAO-B in the brain, producing antidepressant effects, without substantially inhibiting MAO-A in the gastrointestinal tract, thereby reducing the risk of hypertensive crisis. The doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with transdermal selegiline. official website and that any information you provide is encrypted Serotonin syndrome and the combined use of deprenyl and an antidepressant in Parkinsons disease. Atypical depression: Unipolar depressive subtype with preferential response to MAOIs. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Call your care team if you get a fever. Shahid Salaria, PhD, of Medicus International provided editorial support. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Follow your doctor's orders or the directions on the label. NOTE: This medicine is only for you. Skip to content Care at Mayo Clinic Care at Mayo Clinic About Mayo Clinic Request Appointment Disclosure: Funding was provided by Bristol-Myers Squibb. A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants ('mood elevators') such as transdermal selegiline during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Remove the patch from the pouch by tearing at the notches on the sides of the pouch. Promptly consult your doctor or. HAM-D-17 scores were also better at the endpoint but not significantly (STS = 14.7 7.2 vs. placebo = 16.3 7.1; P = 0.06). At the effective selegiline dose of 6 mg every 24 hours, the systems dermal application enables targeted inhibition of MAO enzymes in the CNS without significantly increasing sensitivity to dietary tyramine, thus eliminating the need for dietary modifications of foods containing tyramine at this dose.21. Side effects that you should report to your care team as soon as possible: Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome): This list may not describe all possible side effects. Selegiline skin patch is used to treat mental depression in adults. Check with your pharmacy or law enforcement to find a location. Check with your doctor immediately if any of the following side effects occur: Some side effects may occur that usually do not need medical attention. If you forget to change your patch after 24 hours, remove the old patch, apply a new patch as soon as you remember and continue your regular dosing schedule. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Your condition may begin to improve after you have used transdermal selegiline for one week or longer. Richard IH, Kurlan R, Tanner C, et al. In particular, the STS provides several advantages to orally administered MAOIs, including freedom from dietary tyramine modifications at a dose of 6 mg/24 hours and a favorable side-effect profile. These may also include alcoholic beverages or alcohol-free or reduced-alcohol beer and wine. Amsterdam JD, Shults J. MAOI efficacy and safety in advanced stage treatment-resistant depression: A retrospective study. Peel the first piece of liner off the sticky side of the patch. Pheochromocytoma (an adrenal gland problem)Should not be used in patients with this condition. Selegiline transdermal system: current awareness and promise. Patients who completed the study also experienced a significantly longer time to relapse over 52 weeks, compared with those receiving placebo (P = 0.005). Children 12 years of age and olderUse and dose must be determined by your doctor. Get rid of any unused medication after the expiration date. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Mitchell RS. 12. Pharmacologic approaches to treatment resistant depression: a re-examination for the modern era. The patch should not be applied to an area of skin that is irritated, broken, scarred, or calloused, and a new application site should be selected with each new patch to avoid a reaction at the site. Current Pharmaceutical Treatments and Alternative Therapies of Parkinson's Disease. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Dr. Azzaro is President of AJA PharmaServices in Tarpon Springs, California. Blackwell B, Marley E. Interactions of cheese and of its constituents with monoamine oxidase inhibitors. In a long-term, double-blind, placebo-controlled relapse-prevention study, 322 patients who had responded to 10 weeks of open-label STS 6 mg/24 hours were randomly selected to receive either transdermal selegiline 6 mg/24 hours or placebo once daily for up to 52 weeks. Selegiline transdermal system is safe and effective in treating major depressive disorder at the dose range of 6 - 12 mg/24 h, without the need for dietary precautions at the 6 mg/24 h dose. Do not touch your eyes until after you have washed your hands. No dietary tyramine restrictions were required. Tyramine and irreversible monoamine oxidase inhibitors in clinical practice. Fluoxetine and selegiline: Lack of significant interaction. You should avoid or limit the use of alcohol while being treated with selegiline. Transdermal selegiline: the new generation of monoamine oxidase inhibitors. Duplication for commercial use must be authorized by ASHP. 2007 Feb;28(2):223-8. doi: 10.1080/01612840601096461. Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity. FOIA Wash the area of skin where you will apply the patch gently with soap and warm water. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information. dose, transdermal selegiline has minimal effect on MAO A, and there need be no dietary restrictions. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. Amsterdam JD. Do not take other medicines unless they have been discussed with your doctor. No dietary restrictions. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Given their positions in the pathway of care, pharmacists and physicians play a major role in counseling patients about the potential for drug interactions and alternative treatments. This dose can produce antidepressant effect without the need for dietary restrictions. Transdermal selegiline controls depression but does not cure it. The site is secure. Baker GB, Urichuk LJ, McKenna KF, et al. No matter what your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. Before you have any kind of surgery, tell the medical doctor in charge that you or your child are using this medicine. No cases of hypertensive crisis were reported in any of the controlled clinical trials. A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants ('mood elevators') such as transdermal selegiline during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Feiger AD, Rickels K, Zimbroff DL, et al. You should know that your mental health may change in unexpected ways when you take transdermal selegiline or other antidepressants even if you are an adult over age 24. If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely. In case of overdose, call the poison control helpline at 1-800-222-1222. Nierenberg AA. However, the chance exists that dangerous reactions, such as sudden high blood pressure, may occur if higher doses are used with certain foods or beverages. 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