Selegiline is extensively metabolized by several CYPThe potential for selegiline or N-desmethylselegiline to inhibit individual CYPApproximately 10% and 2% of a radiolabeled dose applied dermally, as a DMSO solution, was recovered in urine and feces respectively, with at least 63% of the dose remaining unabsorbed. The 12 mg Emsam patch has been a literal life saver for me. Selegiline has a greater affinity for MAO-B, compared to MAO-A. "WIRED is where tomorrow is realized. Selegiline and its metabolites are present in the milk of lactating rats (Because of the potential for serious adverse reactions in breastfed infants from Emsam, including the potential for hypertensive crisis, advise a woman that breastfeeding is not recommended during treatment with Emsam and for 5 days after the final dose.In a prenatal and postnatal development study where rats were treated with transdermal selegiline at doses approximately 8, 24, and 60 times the MRHD on days 6 to 21 of gestation and days 1 to 21 of the lactation period, concentrations of selegiline and its metabolites in milk were approximately 15 and 5 times, respectively, the concentrations in maternal plasma.Use of Emsam in patients less than 12 years of age is contraindicated because of the potential for a hypertensive crisis Limited pharmacokinetic data with doses lower than in the commercially available formulations suggest that children under age 12 may be exposed to increased levels of selegiline compared to adolescents and adults, administered with and without dietary modifications, therefore, there may be an increased risk of hypertensive crisis, even at the lowest dose of Emsam.Efficacy has not been established in pediatric patients ages 12 to 17 years with MDD and Emsam is not recommended for use in this age range A multi-center, randomized, double-blind, placebo-controlled, flexible-dose trial in 308 adolescents (ages 12 to 17 years) with MDD failed to demonstrate the efficacy of Emsam. Most of these effects were seen at the high dose in both rats and rabbits. See “Who should not use Emsam?”Call your doctor for medical advice about side effects. No hypertensive crises were reported in any patient receiving Emsam.Overall, the data for Emsam 6 mg per 24 hours support a recommendation that a modified diet is not required at this dose. The only adverse reaction associated with discontinuation, in at least 1% of Emsam-treated patients at a rate at least twice that of placebo, was application site reaction (2% Emsam vs. 0% placebo).Table 2 enumerates adverse reactions that occurred at an incidence of 2% or more (rounded to the nearest percent) among 817 MDD patients treated with Emsam in doses ranging from 3 to 12 mg per 24 hours in placebo-controlled trials of up to 8 weeks in duration. Call your doctor for medical Women who discontinued antidepressant medication during pregnancy showed a significant increase in relapse of their major depression compared to those women who remained on antidepressant medication throughout pregnancy.In an embryofetal development study, rats were treated with transdermal selegiline during the period of organogenesis at doses of 10, 30, and 75 mg/kg/day (8, 24, and 60 times the MRHD of Emsam [12 mg/24 hours] on a mg/mIn an embryofetal development study, rabbits were treated with transdermal selegiline during the period of organogenesis at doses of 2.5, 10, and 40 mg/kg/day (4, 16, and 64 times the MRHD on a mg/mIn a prenatal and postnatal development study, rats were treated with transdermal selegiline at doses of 10, 30, and 75 mg/kg/day (8, 24, and 60 times the MRHD on a mg/mThere is no information regarding the presence of selegiline in human milk, or on its effects on milk production or the breastfed infant. The stated frequencies of adverse reactions represent the proportion of individuals who experienced, at least once, a treatment-emergent adverse reaction of the type listed.