Rivastigmine (Absorbed through the skin)

Introduction

Rivastigmine (riv-a-STIG-meen)

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

Brand Name(s)

Exelon

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

When This Medicine Should Not Be Used

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. Try 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.
• 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. Do not put a new patch in the same place for at least 14 days.
• 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 put cream, lotion, ointment, oil, or powder on the skin area where the patch will be placed.
• Do not touch your eyes after you touch the patch.
• 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 has fallen off and cannot be reapplied.

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.

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 bethanechol (Urecholine®), succinylcholine (Anectine®), or other muscle relaxant medicine. Tell your doctor if you are using a pain or arthritis medicine (sometimes called "NSAIDs") such as aspirin, ibuprofen, naproxen, Advil®, Aleve®, Bextra®, Celebrex®, Ecotrin®, or Motrin®.

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have heart disease, heart rhythm problems, seizures or tremors, trouble urinating, or history of stomach or bowel ulcers, asthma, or other breathing problems. Tell your doctor if you smoke or have a low body weight (below 50 kilograms).
• Having more than one patch on your body at the same time can cause you to get too much of this medicine. Make sure you remove the used patch before wearing a new one to decrease your risk of having serious side effects. If you accidentally use more than one patch at a time, call your doctor right away.
• You may have nausea, severe vomiting, loss of appetite, diarrhea, and weight loss while using rivastigmine. This medicine may also cause or worsen seizures or tremors. Talk with your doctor before using this medicine if you have any concerns.
• Do not stop using this medicine without asking your doctor. If you have not used your medicine for several days in a row, do not start using it again without talking to your doctor first. You may need to start the medicine again using a lower dose.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• 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.

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
• Change in how much or how often you urinate, painful urination.
• Chest pain.
• Dry mouth, increased thirst, or muscle cramps.
• Eye pain, changes in vision.
• Fast, slow, or uneven heartbeat.
• Lightheadedness or fainting.
• Red or black stools.
• Seizures or tremors.
• Sudden and severe stomach pain, nausea, vomiting, or fever.
• Swelling in your hands, ankles, or feet.
• Unusual bleeding, bruising, or weakness.

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

• Anxiety or depression.
• Dizziness or headache.
• Loss of appetite or weight loss.
• Mild nausea, vomiting, diarrhea, or stomach pain.
• Tiredness.
• Trouble sleeping.