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Re: Emsam skin reactions » Larry Hoover

Posted by softheprairie on July 12, 2009, at 0:22:39

In reply to Re: Emsam skin reactions » kiddo718, posted by Larry Hoover on July 1, 2009, at 9:40:12

> The reaction you describe is most probably contact dermatitis caused by the adhesive. I've looked into the subject pretty thoroughly in the past, and I never found any solution for the problem, because it's a sensitization reaction. Once you're sensitized.....
>
> The value in using transdermal delivery of selegiline is that it bypasses first pass metabolism in the gut and liver. Some people have suggested that liquid or quick-dissolving tablets placed under the tongue might have similar bypass characteristics.
>
> Lar

Yes to the last sentance's reference to the same active ingredient, selegiline, in orally-disintigrating tablet form, which also bypasses the gut! It is only available in the name brand form of Zelapar, and I luckily had good coverage for it, because its price for the kind of dosing I needed (taking something like 12 or 14 pills a day of it at the 1.25 mg strength) was astronomical.
I too was very annoyed at the dermatological problems with the Emsam patches, and asked my pdoc if I could try it in another form, which is how I got to use Zelapar. I was his only person on it, I'm pretty sure.
(I referred to it as bypassing the gut, but I should say that I was instructed to treat it the same as I had the 12 mg Emsam patch and to follow the MAOI dietary restrictions to be on the safe side.)

 

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URL: http://www.dr-bob.org/babble/20090709/msgs/906336.html