Emsam Warnings and Precautions

Some Emsam Warnings and Precautions

Some Emsam warnings and precautions to be aware of include:
  • Emsam has several potentially lethal food and drug interactions. In order to take Emsam safely, you must commit to avoiding many medications, including many non-prescription drugs. Always check with your healthcare provider before taking any medications (see Emsam Drug Interactions and Emsam Food Interactions for more information).
  • Emsam can cause a hypertensive crisis, which is a life-threatening increase in blood pressure. Because of this, you should not take Emsam 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), since increases in blood pressure can be especially dangerous if you have these conditions. For this same reason, you also should not take Emsam 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 Emsam 6 mg per day do not need to follow a special diet. However, those taking high Emsam doses 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 Emsam under any circumstances. Even the smallest available Emsam dose is too high for such children, and dangerous side effects could occur.


  • Antidepressants (including Emsam) 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 Emsam, 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 Emsam 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 Emsam 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 Emsam.
  • Emsam should be used with caution in people who have recently had a heart attack or who have unstable heart disease.
  • Do not cut the Emsam 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 Emsam 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, Emsam 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 Emsam should use caution when driving, operating heavy machinery, or performing other tasks that require concentration -- especially when first starting Emsam or when switching dosages. This is because Emsam may affect a person's mental or physical ability to perform these tasks. Make sure to understand how Emsam affects you before performing any task that requires mental or physical concentration.
  • Emsam is considered a pregnancy Category C medication. This means that Emsam may not be safe to use during pregnancy. Talk with your healthcare provider about the risks and benefits of using Emsam during pregnancy (see Emsam and Pregnancy for more information).
  • It is not known if Emsam 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 Emsam, and certain Emsam side effects may be more dangerous in elderly people.
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