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Emsam Food Interactions

If you eat certain foods with high amounts of tyramine while taking high doses of Emsam, food interactions may occur. When these interactions occur, it may cause your tyramine levels to become too high, which can be extremely dangerous. If you are taking more than 6 mg per day of Emsam, you should avoid any foods that are spoiled, fermented, or aged. Some of these foods include pepperoni, all aged cheeses, and sauerkraut.

 

An Overview of Emsam Food Interactions

Emsam® (selegiline transdermal patch) is a prescription medication used to treat depression. It is part of a group of medications called monoamine oxidase inhibitors (MAOIs). As with other MAOI antidepressants, there are many dangerous food interactions with Emsam. However, people taking the lowest dose (Emsam 6 mg per day) do not usually need to follow a special diet.
 

Causes of Emsam Food Interactions -- The Tyramine Effect

Monoamines are a certain type of chemical in the body. Some examples of monoamines include dopamine, norepinephrine, epinephrine, serotonin, melatonin, histamine, and several others. Monoamine oxidase is an enzyme that breaks down monoamines. MAOI medications block the action of monoamine oxidase, causing an increase in the level of monoamines in the body. In people with depression, the level of monoamines can be low, so increasing the monoamines usually helps with symptoms of depression.
 
There are also monoamine oxidase enzymes in the digestive tract, and these enzymes are responsible for breaking down tyramine, a naturally occurring chemical (found in many foods and beverages) that affects blood pressure. MAOI medications stop the body's ability to break down tyramine and can cause a person's tyramine levels to become too high (which can be extremely dangerous).
 
While most MAOIs block the action of monoamine oxidase in the digestive tract (because they are taken by mouth), Emsam (when used at the lowest dose, Emsam 6 mg) has little effect on digestive monoamine oxidase, since it is absorbed into the skin through a patch. However, higher Emsam doses may be more likely to interact with tyramine-rich foods. Because tyramine is found in many foods and beverages, people taking more than 6 mg of Emsam per day must follow a strict diet.
 
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;