Do not use Emsam if:

• you are allergic to any ingredient in Emsam;
• you are taking fluoxetine or have taken it within the past 5 weeks;
• you 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;
• 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;
• 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;
• you have certain adrenal gland problems (eg, pheochromocytoma).

• Emsam may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Emsam with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol while you are using Emsam.
• Emsam may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
• Do not suddenly stop using Emsam. The risk of side effects may be increased if Emsam is suddenly stopped. Check with your doctor before you change your dose or stop Emsam.
• Children, teenagers, and young adults who take Emsam may be at increased risk for suicidal thoughts or actions. Watch all patients who take Emsam closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
• Avoid dietary supplements containing tyramine or nonprescription products containing dextromethorphan, pseudoephedrine, or phenylephrine while you are using Emsam System.
• Tell your doctor or dentist that you take Emsam before you receive any medical or dental care, emergency care, or surgery. Emsam should be discontinued at least 10 days before elective surgery.
• If your doctor tells you to stop taking Emsam, you will need to wait at least 14 days before beginning to take certain other medicines (e.g., medicines for depression, anxiety, pain, cough, congestion, weight loss, seizures, or Parkinson disease; muscle relaxants). Ask your doctor if you are unsure when you should start to take your new medicines after you have stopped taking Emsam.
• Diabetes patients - Emsam may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.

Check with your doctor if any of these most common side effects persist or become bothersome:

• diarrhea; dizziness; dry mouth; sleeplessness.

• 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.

Emsam is to be used only by the patient for whom it is prescribed. Do not share it with other people.
If your symptoms do not improve or if they become worse, check with your doctor.