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

What is Exelon?

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

Exelon skin patches are 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

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

Call your doctor at once if you have severe or ongoing vomiting or diarrhea, loss of appetite, weight loss, heavy sweating or hot and dry skin, black or bloody stools, coughing up blood, tremors (uncontrolled shaking), or restless muscle movements in your eyes, tongue, jaw, or neck.

Slideshow: Flashback: FDA Drug Approvals 2013

You should not use this medication if you have ever had severe redness, itching, or skin irritation where a Exelon skin patch was worn.

Before using Exelon, tell your doctor if you have liver disease, a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats), recent weight loss or lack of appetite, 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 one Exelon patch at a time.

Before using Exelon

You should not use Exelon if you are allergic to rivastigmine or similar medications (felbamate, carisoprodol, meprobamate) or if you have ever had severe redness, itching, or skin irritation where a Exelon skin patch was worn.

To make sure Exelon is safe for you, tell your doctor if you have:

  • liver or kidney disease;

  • recent weight loss or lack of appetite;

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

  • an enlarged prostate or urination problems;

  • epilepsy or other seizure disorder;

  • asthma or other breathing disorder;

  • a history of stomach ulcer; 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.

See also: Pregnancy and breastfeeding warnings (in more detail)

Rivastigmine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Exelon.

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. Your doctor may occasionally change your dose to make sure you get the best results. Follow the directions on your prescription label.

This medication 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 patch to a flat and hairless area of your chest, upper or lower back, or the outer part of your upper arm. Press the patch firmly into place for about 10 seconds to make sure it sticks. You may leave the patch on while bathing, showering, or swimming.

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.

Remove the Exelon skin patch after 24 hours and replace it with a new one.

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

Choose a different place on your body to wear the patch each time you put on a new one. Do not use the same skin area twice within 14 days.

Avoid placing the 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.

Do not wear more than one Exelon patch at a time. Using extra skin patches will not make the medication more effective. Never cut a skin patch.

Always wash your hands after removing the Exelon patch.

After removing a patch, fold it in half so it sticks together and throw it away in a place where children or pets cannot get to it.

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

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

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 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?

If you forget to change the skin patch, remove it and apply a new one as soon as you remember. Do not wear extra patches to make up a missed dose.

Call your doctor for instructions if you miss more than 3 doses of Exelon.

What happens if I overdose?

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

What should I avoid?

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

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 skin 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.

Avoid touching your eyes after handling a skin patch.

Exelon side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Exelon: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • redness, swelling, or irritation where the skin patch is worn;

  • a light-headed feeling, like you might pass out;

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

  • pain or burning when you urinate;

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

  • seizures (convulsions);

  • severe or ongoing vomiting or diarrhea with weight loss; or

  • if you feel very thirsty or hot, are unable to urinate, and have heavy sweating or hot and dry skin.

Common Exelon side effects may include:

  • nausea, vomiting, upset stomach;

  • loss of appetite; or

  • weakness.

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: 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.

Other drugs may interact with rivastigmine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about Exelon.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Exelon only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. 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. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 3.03. Revision Date: 2014-01-23, 11:33:08 AM.

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