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Rivastigmine transdermal

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

Medically reviewed by on Apr 24, 2017 – Written by Cerner Multum

What is rivastigmine transdermal?

See also: Gocovri

Rivastigmine improves 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.

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

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

Important Information

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

Before taking this medicine

You should not use this medicine 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 rivastigmine transdermal skin patch was worn.

To make sure rivastigmine 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.

This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

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

How should I use rivastigmine transdermal?

Use 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.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Never cut or tear a rivastigmine 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 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 rivastigmine 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 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 rivastigmine transdermal. You may need to stop using the medicine for a short time.

If you stop using rivastigmine transdermal 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 rivastigmine.

What happens if I overdose?

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

What should I avoid while using rivastigmine transdermal?

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.

Rivastigmine transdermal side effects

Get emergency medical help if you have signs of an allergic reaction: 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 side effects may include:

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.

Rivastigmine transdermal dosing information

Usual Adult Dose for Alzheimer's Disease:

-Initial dose: 1.5 mg orally twice a day
-Maintenance dose: After a minimum of 2 weeks of treatment, if the initial dosage is well tolerated, it can be increased to 3 mg twice a day; subsequent increases to 4.5 mg and 6 mg twice a day should be attempted only after a minimum of 2 weeks at the previous dosage

-Initial Dose: 4.6 mg/24 hour patch applied to the skin once daily
-Maintenance Dose: After a minimum of 4 weeks of treatment at the initial dose, and if well tolerated, the dose can be increased to 9.5 mg/24 hours for as long as this dose is beneficial; the dose can then be increased to 13.3 mg/24 hours
-Maximum Dose: 13.3 mg/24 hour patch applied to skin daily; higher doses confer no appreciable additional benefit, and are associated with significant increase in the incidence of adverse events

-Recommended dose: 13.3 mg/24 hours transdermal patch applied to skin once daily; replace with a new patch every 24 hours

Use: For the treatment of mild, moderate, or severe dementia of the Alzheimer's type (AD)

Usual Adult Dose for Parkinson's Disease:

Initial dose: 1.5 mg orally twice a day with morning and evening meals
Maintenance dose: Subsequently, the dose can be increased to 3 mg orally twice a day and further to 4.5 mg twice a day and 6 mg twice a day (based on tolerability) with a minimum of 4 weeks at each dose

Initial dose: 4.6 mg/24 hours applied to the skin once a day
Maintenance dose: After a minimum of four weeks of treatment and if well tolerated, the dose of the patch can be increased to 9.5 mg/24 hours for as long as this dose is beneficial. The dose can then be increased to 13.3 mg/24 hours.
Maximum dose: 13.3 mg/24 hours. Higher doses confer no appreciable additional benefit, and are associated with significant increase in the incidence of adverse events.

Use: For the treatment of mild to moderate dementia associated with Parkinson's disease

What other drugs will affect rivastigmine transdermal?

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

Tell your doctor about all your current medicines and any you start or stop using, especially:

This list is not complete. Other drugs may interact with rivastigmine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.