How does Emsam affect other medicines and food?

There are some potential interactions between Emsam (selegiline) with food and other medications. Tyramines are proteins found in foods that might raise blood pressure when taken while on Emsam. Monoamine oxygenase (MAO) is an enzyme that breaks down these naturally occurring enzymes in the body. Emsam is an MAO inhibitor, which means it stops or slows down this breakdown. So, it is important that people using Emsam do not eat a lot of food containing tyramine or their blood pressure could elevate.

People using Emsam should avoid tyramine-rich foods like aged cheese; meats that are dried; aged or fermented, fava beans; beer; concentrated yeast extracts; soy sauce, tofu and other soy products, as well as most fermented products. Some nutritional supplements contain large amounts of tyramine and should be avoided. People who are using Emsam should not drink alcohol, and using cocaine while on Emsam can be very dangerous.

Carbamazepine (Tegretol) should not be taken as it can increase blood levels of Emsam. It can also increase the blood pressure elevation effect of medicines like amphetamines, pseudoephedrine, phenylephrine and ephedrine.

Other medications that may interact with Emsam include: antidepressants, such as other MAO-inhibitors, Prozac, Zoloft, Paxil, amitriptyline, imipramine, venlafaxine, duloxetine, mirtazipine, bupropion, St. John's Wort. Pain medicines like Demerol, tramadol and methadone should also be avoided, as well as the cough medicine dextromethorphan.