Exelon Transdermal

Generic Name: rivastigmine transdermal (riv a STIG meen)
Brand Names: Exelon

What is Exelon?

Exelon (rivastigmine) improves the function of nerve cells in the brain. Rivastigmine works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.

Exelon transdermal (skin patch) is used to treat mild to moderate dementia caused by Alzheimer's or Parkinson's disease.

Exelon may also be used for purposes not listed in this medication guide.

Important information about Exelon

You should not use Exelon if you are allergic to rivastigmine.

Before using Exelon, tell your doctor if you have liver disease, a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats), an enlarged prostate, urination problems, a seizure disorder, asthma or allergies, tremors or uncontrolled muscle movements, or a history of stomach ulcer.

Always remove an old patch before putting on a new one. Do not wear more than 1 patch at a time. Stop using Exelon and call your doctor at once if the medicine causes you to have nausea and vomiting, loss of appetite, or weight loss.

If you stop using Exelon for any reason, do not restart the medication without talking to your doctor first. You may need to restart treatment with a lower dose.

If you need surgery, tell the surgeon ahead of time that you are using Exelon.

Exelon may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Before using Exelon

You should not use Exelon if you are allergic to rivastigmine.

To make sure you can safely use Exelon, tell your doctor if you have any of these other conditions:

• liver disease;

• recent weight loss or lack of appetite;

• a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats);

• a history of stomach ulcer;

• an enlarged prostate or urination problems;

• epilepsy or other seizure disorder;

• asthma or any allergies; or

• tremors (dyskinesia) or uncontrolled muscle movements.

FDA pregnancy category B. Exelon is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether rivastigmine passes into breast milk or if it could harm a nursing baby. Do not use Exelon without telling your doctor if you are breast-feeding a baby.

See also: Exelon pregnancy and breastfeeding warnings (in more detail)

How should I use Exelon?

Use Exelon exactly as prescribed by your doctor. Do not apply more patches or use them for longer than recommended. Follow the directions on your prescription label.

Exelon comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Never cut or tear a Exelon patch.

Apply the skin patch to a flat, hairless area of the chest, back, side, or outer side of your upper arm. Press the patch firmly with the palm making sure it sticks firmly, especially around the edges.

Avoid placing the Exelon patch where it will be rubbed by tight clothing, or in the folds of your skin. The patch should remain flat on the skin at all times. Take care to avoid accidentally removing the patch while showering or during physical activity.

You will wear the Exelon patch for 24 hours and then remove it and put on a new one. Apply the new patch to a different skin area on your back each day. Do not use the same spot again for at least 14 days.

Always remove an old Exelon patch before putting on a new one. Do not wear more than 1 patch at a time.

If a patch falls off, apply a new patch and wear it for the rest of the day. Change the patch at your usual time the next day.

After removing a Exelon skin patch fold it in half, sticky side in, and throw it away where children and pets cannot get to it.

Always wash your hands after removing the patch.

If you need surgery, tell the surgeon ahead of time that you are using Exelon. You may need to stop using the medicine for a short time.

It may take up to 4 weeks of using Exelon transdermal before your symptoms improve. For best results, keep using the patches as directed.

If you stop using Exelon for any reason, do not restart the medication without talking to your doctor first. You may need to restart treatment with a lower dose.

Store Exelon at room temperature away from moisture and heat. Keep each patch in its foil pouch until you are ready to use it.

What happens if I miss a dose?

Apply a skin patch as soon as you remember. Or you may wait until the next day to apply a patch and skip the missed dose. Do not use extra patches to make up the missed dose.

If you miss several doses in a row, call your doctor before using any more of Exelon.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe nausea, vomiting, diarrhea, slow heartbeat, slow or shallow breathing, or hallucinations.

What should I avoid while using Exelon?

Do not use any cream, lotion, ointment, oil, or powder on the skin where you plan to apply a skin patch. The patch may not stick well to the skin.

Avoid applying heat to the sin where the patch is worn, because it may increase the amount of medicine your body absorbs. Heat sources include hot tubs, heating pads, heat lamps, saunas, heated water beds, and direct sunlight. Exelon may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Exelon side effects

Get emergency medical help if you have any of these signs of an allergic reaction to an Exelon patch: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Exelon and call your doctor at once if you have a serious side effect such as:

• nausea and vomiting, loss of appetite, weight loss;

• black or bloody stools, coughing up blood or vomit that looks like blood or coffee grounds;

• restless muscle movements in your eyes, tongue, jaw, or neck, tremor (uncontrolled shaking);

• sudden numbness or weakness, headache, confusion, problems with vision, speech, or balance;

• pale skin, easy bruising or bleeding;

• confusion, hallucinations; or

• pain or burning when you urinate.

Less serious Exelon side effects may include:

• diarrhea, stomach pain;

• headache, tired feeling;

• anxiety, depressed mood;

• redness, itching, or swelling where the patch was worn;

• dizziness, spinning feeling; or

• sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Exelon side effects (in more detail)

What other drugs will affect Exelon?

Do not take rivastigmine capsules or oral liquid at the same time you are wearing the skin patch.

The following drugs can interact with Exelon. Tell your doctor if you are using any of these:

• atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);

• bronchodilators such as ipratroprium (Atrovent) or tiotropium (Spiriva);

• glycopyrrolate (Robinul);

• mepenzolate (Cantil);

• bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

• irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine);

• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others; or

• medicines used to treat Parkinson's Disease such as levodopa (Dopar, Larodopa, Sinemet, Atamet, others), bromocriptine (Parlodel, others), pergolide (Permax), pramipexole (Mirapex), or ropinirole (Requip).

This list is not complete and other drugs may interact with Exelon. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Exelon.

• Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2011 Cerner Multum, Inc. Version: 2.01. Revision Date: 2/14/2011 11:26:23 AM.