Rivastigmine (riv-a-STIG-meen)

Treats dementia.

Brand Name(s):

Exelon

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.
• 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. Do not use this medicine if the pouch seal is broken or if the patch is damaged in any way.
• 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. You can use the same area, but do not use the exact same spot for at least 14 days.
• Apply the patch to clean, dry, intact skin on your upper back, lower back, upper arms, or chest that has very little to no hair. Do not shave the skin where you will apply the patch. You may cut the hair with a pair of scissors. Do not put the patch over burns, cuts, or irritated skin. Avoid putting the patch over skin folds, across the spine, or on areas where it could be rubbed by tight clothing or undergarments.
• Place the sticky side against the skin and peel off the other side of the protective cover. Press down on the patch firmly for 30 seconds to make sure that edges of the patch stick to your skin.
• If the patch falls off, throw it away and apply a new patch in a different area.
• Do not put cream, lotion, or powder on the skin area where the patch will be placed.
• Do not touch your eyes after applying the patch. Rinse it off right away with water if it does get in your eyes or if your eyes become red after touching the patch.
• Choose a different place on your skin to apply the next patch. You can use the same area, but do not use the exact same spot for at least 14 days after your last application.
• Fold the used patch in half and put it back into the pouch you saved.
• Put on a new patch if the old one has fallen off and cannot be reapplied.
• Keep the patch away from heat, including excessive sunlight, saunas, sun rooms, or heating pads.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Missed dose: 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.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how rivastigmine works. Tell your doctor if you are using any of the following:
  • Metoclopramide, oxybutynin, tolterodine
  • Blood pressure medicine (including atenolol or other beta-blockers)
  • NSAIDs

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart disease, seizures, or a history of lung or breathing problems (including asthma or COPD) or stomach ulcers.
• This medicine may cause the following problems:
  • Serious skin reactions
  • Stomach or bowel problems, including bleeding or ulcers
  • Heart problems
  • Seizures
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Make sure any doctor who treats you knows that you have this patch before having surgery or other medical procedures.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

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
• Blistering, peeling, itching, redness, or swelling of the skin where the patch is applied
• Bloody or black stools, vomiting of blood or material that looks like coffee grounds
• Change in how much or how often you urinate
• Diarrhea, nausea, vomiting
• Fast, slow, or uneven heartbeat
• Seizures

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

• Headache, dizziness
• Loss of appetite, weight loss

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