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Mode of Application
Emsam can be taken by mouth with or without food with a glass of water. The best way to use the drug is as recommended by your doctor.
Drug Class & Mechanism of Action
Emsam is a monoamine oxidase inhibitor (MAOI). The exact working procedure of this drug is not known.
If you miss a dose of Emsam then you may take it as soon as you remember and adjust the remaining doses accordingly. However, if it is nearly time for the next dose then you may skip this dose and continue with the regular dosage. Do not take a double dose to make up for the missed dose.
Store it at room temperature (between 68 and 77 degrees F (20 and 25 degrees C) in an air tight container protecting it from direct exposure to light, heat and moisture. Keep away from pets and children.
Discuss with your doctor about any prior medical condition that you may have including allergies to medicines, food or other substances, you have a history of bipolar disorder, mania, mood or mental problems, suicidal thoughts or attempts, or uncontrolled muscle movements (eg, twitching of the face and tongue and involuntary movements of the arms and legs), have a history of ulcer, heart problems, recent heart attack, seizures, blood problems, or a metabolism disorder.
You must not take if you are allergic to any ingredient in it or are taking fluoxetine or have taken it within the past 5 weeks, are taking bupropion, buspirone, cyclobenzaprine, dextromethorphan, meperidine, methadone, a norepinephrine reuptake inhibitor (e.g., atomoxetine), propoxyphene, a selective serotonin reuptake inhibitor (SSRI) (e.g., paroxetine), a serotonin and norepinephrine reuptake inhibitor (e.g., duloxetine, venlafaxine), St. John's wort, a tetracyclic antidepressant (e.g., mirtazapine), tramadol, or a tricyclic antidepressant (e.g., amitriptyline), or if you have taken any of these medicines within the past 7 days, if you are taking another MAOI (e.g., phenelzine), a sympathomimetic, including an amphetamine, a cold product, or certain diet pills or preparations (e.g., ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine), or sibutramine, or if you have taken any of these medicines within the past 7 days, if you are taking a 5-HT agonist (e.g., sumatriptan), apraclonidine, carbamazepine, methylphenidate, oxcarbazepine, or nefazodone, you will be undergoing elective surgery with general anesthesia or will be receiving cocaine or local anesthesia containing sympathomimetic vasoconstrictors and lastly, you have certain adrenal gland problems (eg, pheochromocytoma).
If you are pregnant or suspect that you are, then stop using Emsam and contact your doctor immediately.
It is unknown whether Emsam is secreted in breast milk. Avoid breast feeding while using the drug.
Certain drugs can interact with and hence, mention clearly to your doctor or pharmacist all medicines, dietary supplements and herbal prescriptions that you are taking, especially the following.
Bupropion, cyclobenzaprine, dextromethorphan, a MAOI (eg, phenelzine), meperidine, methadone, a norepinephrine reuptake inhibitor (eg, atomoxetine), oral selegiline, propoxyphene, a serotonin or norepinephrine reuptake inhibitor (eg, duloxetine, venlafaxine), sibutramine, a SSRI (eg, fluoxetine), St. John's wort, sympathomimetics (eg, amphetamine , ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine), a tetracyclic antidepressant (eg, mirtazapine), or a tricyclic antidepressant (eg, amitriptyline) because serotonin syndrome (eg, fever, muscle stiffness or rigidity, vital sign changes, mental or mood changes, coma) may occur.
Apraclonidine or buspirone because it may lead to severe high blood pressure.
Nefazodone or tryptophan because nausea, dizziness, mental or mood changes, seizures, fever, or breathing or heart problems may occur.
Tramadol because it increases the risk of seizures.
Carbamazepine or oxcarbazepine because they may increase the risk of Emsam's side effects 5-HT1 agonists (eg, sumatriptan), insulin, a meglitinide antidiabetic (eg, nateglinide), methylphenidate, or a sulfonylurea (eg, glipizide) because the risk of their side effects may be increased by Emsam.
Some of the common side effects of Emsam are diarrhea, dizziness, dry mouth, sleeplessness. Please contact your doctor if the symptoms persist or become bothersome.
Other severe side effects include severe allergic reactions (rash, hives, itching, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue), abnormal thinking, changes in sexual ability or desire, chest pain, enlarged pupils, fast, slow, or irregular heartbeat, increased sweating, memory loss, nausea, neck stiffness or soreness, new or worsening agitation, aggressiveness, anxiety, exaggerated feeling of well-being, hostility, impulsiveness, inability to sit still, irritability, panic attacks, or sleeplessness, painful menstruation, sensitivity to light, severe headache, swelling of the arms or legs, vomiting.
You must seek medical attention immediately if any of these side effects occur.