Medication Interactions
Over-the-counter items that can not be used while on Emsam include: St. John's Wort; products containing dextromethorphan such as cough and cold preparations; decongestant medicines; and diet pills or herbal weight loss products. Caffeine and chocolate can only be consumed in small amounts.
There are prescription medications that can not be taken while using Emsam, and for 2 weeks after stopping Emsam. Some medications must not be taken for 1 week (or more) before an individual can start using Emsam.
Medications that can not be taken because they can cause serotonin syndrome include: (SSRIs), (SNRIs), (TCAs), other MAOIs, mirtazapine, analgesics such as meperidine, tramadol, methadone, propoxyphene, cyclobenzaprine, and oral selegiline. The use of Emsam is contraindicated for use with sympathomimetic amines, including amphetamines as well as cold products and weight-reducing preparations that contain vasoconstrictors (e.g., pseudoephedrine, phenylephrine, phenylpropanolamine, and ephedrine). Carbamazepine and oxcarbazepine are also contraindicated.
Patients taking Emsam should not undergo elective surgery requiring general anesthesia or be given local anesthesia containing sympathomimetic vasoconstrictors.
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