Rivastigmine (Absorbed through the skin)

Introduction

Rivastigmine (riv-a-STIG-meen)

Treats dementia (memory loss and mental changes) associated with Alzheimer disease or Parkinson disease. This medicine is an acetylcholinesterase inhibitor.

Brand Name(s)

Exelon

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

Do not use this medicine if you have had an allergic reaction to rivastigmine or to other acetylcholinesterase inhibitors such as neostigmine (Prostigmin®), physostigmine (Antilirium®), or pyridostigmine (Mestinon®, Regonol®).

How to Use This Medicine

Patch

  • Your doctor will tell you how many patches to use, where to apply them, and how often to apply them. Do not use more patches or apply them more often than your doctor tells you to. Change the patch at the same time each day.
  • This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
  • Wash your hands with soap and water before and after applying a patch. Do not touch your eyes after you touch the patch.
  • Leave the patch in its sealed wrapper until you are ready to put it on. Tear the wrapper open carefully. NEVER CUT the wrapper or the patch with scissors. Do not use any patch that has been cut by accident.
  • The patient instructions will show the body areas where you can wear the patch. When putting on each new patch, choose a different place within these areas. Do not put the new patch on the same place you wore the last one. Be sure to remove the old patch before applying a new one. This patch is usually applied to the upper or lower back, upper arm, or chest. Do not put a new patch in the exact same spot for at least 14 days.
  • Apply the patch to a clean, dry, and hairless skin area. Do not put cream, lotion, or powder on the skin area where the patch will be placed.Do not put the patch over burns, cuts, or irritated skin. Avoid putting the patch on areas where it could be rubbed off by tight clothing.
  • Do not expose the patch to direct sources of heat, such as heating pads, electric blankets, heat lamps, saunas, hot tubs, heated water beds, or direct sunlight for long periods of time.
  • Put on a new patch if the old one falls off. Do not put the old one back on, and do not use tape or a bandage to hold a patch that is loose. The patch should stay in place, even when you are showering, bathing, or swimming.

If a dose is missed:

  • If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.
  • If you go 3 days in a row or longer without wearing a patch, do not apply a new one until you have talked to your doctor. You might need to go back to a lower dose.

How to Store and Dispose of This Medicine

  • Store the patches at room temperature in a closed container, away from heat, moisture, and direct light.
  • Fold the used patch in half with the sticky sides together. Throw any used patch away so that children or pets cannot get to it. You will also need to throw away old patches after the expiration date has passed.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are using an NSAID pain or arthritis medicine, such as aspirin, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, or Voltaren®.
  • Make sure your doctor knows if you also use another acetylcholinesterase inhibitor such as neostigmine (Prostigmin®), physostigmine (Antilirium®), or pyridostigmine (Mestinon®, Regonol®). Tell your doctor if you also use an anticholinergic medicine, such as allergy or cold medicine (diphenhydramine, Benadryl®), medicine to treat bladder or bowel problems (such as dicyclomine, oxybutynin, tolterodine, trospium, Bentyl®, Detrol®, Ditropan®, Sanctura®), asthma medicine (such as ipratropium, Atrovent®), or medicine for motion or travel sickness (such as scopolamine, Transderm-Scop®).

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart disease, or trouble urinating. Tell your doctor if you have a history of ulcers, seizures, or asthma or other breathing problems.
  • Always remove the used patch before you put on a new one, or you could have serious side effects. Wearing more than one patch on your body at the same time can cause you to get too much medicine. If you accidentally use more than one patch at a time, call your doctor right away.
  • This medicine might cause nausea, vomiting, diarrhea, loss of appetite, and weight loss. Tell the doctor if any of these problems are severe, because they could cause other health problems such as dehydration.
  • This medicine may cause changes in your heartbeat. This is more likely if you already have a heart rhythm problem, such as sick sinus syndrome.
  • Do not apply a new patch if you have not worn one for 3 days in a row or longer. Ask your doctor how to start treatment again, because you may need to go back to a lower dose.
  • This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous until you know how this medicine affects you.
  • Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
  • Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Decrease in how much or how often you urinate
  • Bloody or black, tarry stools
  • Seizures, tremors, twitching or muscle movements you cannot control, problems with balance or walking
  • Severe appetite loss or weight loss
  • Severe lightheadedness or fainting
  • Severe nausea, vomiting, diarrhea, stomach pain
  • Slow or uneven heartbeat

If you notice these less serious side effects, talk with your doctor:

  • Dizziness, headache
  • Loss of appetite, weight loss
  • Mild nausea, vomiting, diarrhea
  • Redness or itching where the patch is applied

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last Reviewed on 06/12/2013

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This page was last updated: June 18, 2013

         
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