Rivastigmine patch

Pronunciation

Generic Name: rivastigmine (RIV-a-STIG-meen)
Brand Name: Exelon

Rivastigmine patch is used for:

Treating mild to moderate dementia (eg, impairment of memory or judgment, abstract thinking, changes in personality) in patients with Alzheimer or Parkinson disease.

Rivastigmine patch is a cholinesterase inhibitor. It works by increasing the amount of a certain substance (acetylcholine) in the brain, which may help reduce symptoms of dementia.

Do NOT use rivastigmine patch if:

  • you are allergic to any ingredient in rivastigmine patch or to carbamate derivatives (eg, meprobamate)
  • you are taking another form of rivastigmine (eg, capsules, solution) or another cholinesterase inhibitor (eg, donepezil)
  • you have had severe or persistent skin irritation (eg, red, swollen, or blistered, or peeling skin; warmth; tenderness; itching) around the area where the patch was worn in the past

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Flashback: FDA Drug Approvals 2013

Before using rivastigmine patch:

Some medical conditions may interact with rivastigmine patch. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of kidney or liver problems, certain heart problems (eg, slow or irregular heartbeat, sick sinus syndrome), inflammation of the pancreas (pancreatitis), seizures (eg, epilepsy), stomach or bowel problems (eg, an ulcer), lung or breathing problems (eg, asthma, chronic obstructive pulmonary disease [COPD]), or a urinary blockage (trouble urinating)
  • if you have tremors
  • if you have dementia or other decreased mental ability that is not caused by Alzheimer or Parkinson disease
  • if you are scheduled to have surgery or other medical procedures with general anesthesia
  • if you are dehydrated or if you weigh less than 110 pounds (50 kg)

Some MEDICINES MAY INTERACT with rivastigmine patch. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of stomach or bowel bleeding may be increased
  • Cholinergic agents (eg, bethanechol) or another cholinesterase inhibitor (eg, donepezil) because they may increase the risk of rivastigmine patch's side effects
  • Anticholinergics (eg, scopolamine) because their effectiveness may be decreased by rivastigmine patch

This may not be a complete list of all interactions that may occur. Ask your health care provider if rivastigmine patch may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use rivastigmine patch:

Use rivastigmine patch as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with rivastigmine patch. Talk to your pharmacist if you have questions about this information.
  • Do not cut or tear the patch. Do not apply a patch if the pouch seal is broken or if the patch has been damaged.
  • Apply the patch to the upper or lower back, upper arm, or chest. Use a new application site with each new patch. Do not use the same site within 14 days.
  • Apply to dry, intact skin. Do not apply to an area of skin that is hairy, oily, irritated, broken, scarred, or calloused. Do not apply to an area where cream, lotion, or powder has recently been applied. Do not place the patch under tight clothing.
  • Do not remove the patch from the sealed pouch until you are ready to apply it.
  • To apply the patch, remove the protective liner from 1 side of the patch. Place the sticky side of the patch to the application site, then remove the second side of the protective liner. Press the patch down firmly for 30 seconds until the edges stick well. If you have questions about how to apply the patch, check with your doctor or pharmacist.
  • After 24 hours, remove the used patch. Do not touch the sticky side. Fold the patch in half with the sticky sides together. Discard patch out of the reach of children and away from pets.
  • Wash your hands thoroughly with soap and water after applying or removing a patch. Do not touch your eyes before you have washed your hands. If contact with the eyes happens on accident or if your eyes become red after you have held the patch, rinse right away with water. Call your doctor if symptoms do not go away.
  • You may wear the patch while bathing, swimming, or showering. Make sure the patch does not come loose during these activities.
  • Avoid exposing the application site to direct heat (eg, heating pads or electric blankets, heat lamps, saunas, hot tubs, heated water beds, prolonged direct sunlight) for long periods of time.
  • Wear only 1 patch at a time. Be sure that you remove your old patch before you apply a new one. Wearing more than 1 patch at a time can lead to severe and sometimes deadly overdose. Change the patch at about the same time each day.
  • Do not use bandages or tape to hold down loose patches. Do not reapply patches that have fallen off.
  • Continue to use rivastigmine patch even if you feel well. Do not miss any doses.
  • If your patch falls off or if you miss a dose of rivastigmine patch, apply a new patch to a new site, then return to your regular dosing schedule. Do not apply 2 patches at once. Contact your doctor if you miss applying the patch for 3 or more days. Your doctor may need to restart your medicine at a lower dose to avoid side effects.

Ask your health care provider any questions you may have about how to use rivastigmine patch.

Important safety information:

  • Rivastigmine patch may cause drowsiness, dizziness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use rivastigmine patch with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Rivastigmine patch is for external use only. Do not get it in your mouth.
  • Do NOT use more than the recommended dose, change your dose, or stop using rivastigmine patch without checking with your doctor.
  • When you begin taking rivastigmine patch, your doctor will increase your dose slowly over several months. This may help to decrease the risk of certain side effects (eg, nausea, vomiting, loss of appetite). Carefully follow the dosing schedule prescribed by your doctor.
  • If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions.
  • Tell your doctor or dentist that you take rivastigmine patch before you receive any medical or dental care, emergency care, or surgery.
  • Rivastigmine patch should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using rivastigmine patch while you are pregnant. It is not known if rivastigmine patch is found in breast milk. Do not breast-feed while you are using rivastigmine patch.

Possible side effects of rivastigmine patch:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; headache; loss of appetite; nausea; stomach upset or pain; tiredness; trouble sleeping; vomiting; weakness; weight loss.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; chest pain; confusion; decreased coordination; decreased, increased, or painful urination; dry mouth or eyes; fainting; fever; hallucinations; new or worsening mental or mood changes (eg, agitation, anxiety, depression); new or worsening tremor or uncontrolled muscle movements; new or worsening trouble walking; red, swollen, blistered, or peeling skin; seizures; severe or persistent diarrhea, nausea, stomach pain, or vomiting; severe or persistent dizziness, tiredness, or weakness; severe or persistent loss of appetite or weight loss; severe or persistent skin irritation around where the patch is worn (eg, skin warmth, tenderness, or itching); slow or irregular heartbeat; sluggishness; trouble speaking or swallowing; twitching of the face or tongue; vomit that looks like blood or coffee grounds.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; increased saliva production; loss of consciousness; muscle weakness; seizures; severe dizziness; severe nausea or vomiting; severely increased sweating; slow heartbeat; slow or shallow breathing.

Proper storage of rivastigmine patch:

Store rivastigmine patch at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep rivastigmine patch out of the reach of children and away from pets.

General information:

  • If you have any questions about rivastigmine patch, please talk with your doctor, pharmacist, or other health care provider.
  • Rivastigmine patch is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take rivastigmine patch or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about rivastigmine patch. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to rivastigmine patch. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using rivastigmine patch.

Issue Date: November 5, 2014
Database Edition 14.4.1.002
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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