In particular, it appears to show marked treatment effects in patients showing a more aggressive course of disease, such as those with younger onset ages, poor nutritional status, or those experiencing symptoms such as delusions or hallucinations. No firm evidence supports usage in schizophrenia patients. Its efficacy is similar to donepezil and tacrine. The effects of this kind of drug in different kinds of dementia including Alzheimer's dementia are modest, and it is still unclear which AcCh ButCh esterase inhibitor is better in Parkinson's dementia, though rivastigmine is well-studied.
Side effects[ edit ] Side effects may include nausea and vomiting, decreased appetite and weight loss. Patients and caregivers should be aware of warning signs of potential toxicities and know when to call their doctor. The patient's weight should be monitored during therapy with Exelon transdermal patches. Bradycardia Rivastigmine may cause bradycardia which constitutes a risk factor in the occurrence of torsade de pointes, predominantly in patients with risk factors.
Other adverse reactions Care must be taken when prescribing Exelon transdermal patches: Skin application site reactions Skin application site reactions may occur with rivastigmine patch and are usually mild or moderate in intensity. Patients and caregivers should be instructed accordingly.
These reactions are not in themselves an indication of sensitisation. However, use of rivastigmine patch may lead to allergic contact dermatitis. Allergic contact dermatitis should be suspected if application site reactions spread beyond the patch size, if there is evidence of a more intense local reaction e.
In these cases, treatment should be discontinued see section 4. Patients who develop application site reactions suggestive of allergic contact dermatitis to rivastigmine patch and who still require rivastigmine treatment should only be switched to oral rivastigmine after negative allergy testing and under close medical supervision. It is possible that some patients sensitised to rivastigmine by exposure to rivastigmine patch may not be able to take rivastigmine in any form. There have been rare post-marketing reports of patients experiencing allergic dermatitis disseminated when administered rivastigmine irrespective of the route of administration oral, transdermal.
Other warnings and precautions Rivastigmine may exacerbate or induce extrapyramidal symptoms. Contact with the eyes should be avoided after handling Exelon transdermal patches see section 5.
Hands should be washed with soap and water after removing the patch. In case of contact with eyes or if the eyes become red after handling the patch, rinse immediately with plenty of water and seek medical advice if symptoms do not resolve. Carefully titrate and monitor these patients for adverse reactions e. Patients with clinically significant hepatic impairment may experience more adverse reactions. Dosing recommendations to titrate according to individual tolerability must be closely followed.
Particular caution must be exercised in titrating these patients see sections 4. Rivastigmine does not cure either of these diseases, but it may improve memory, awareness, and the ability to perform daily functions. This medication works by restoring the balance of natural substances neurotransmitters in the brain. How to use Exelon Patch, Transdermal 24 Hours Read the Patient Information Leaflet if available from your pharmacist before you start using this medication and each time you get a refill.
Follow all instructions for how to properly apply and use the patches. If you have any questions, consult your doctor or pharmacist.
Apply the patch to the skin as directed by your doctor, usually once daily. Do not open the sealed pouch until ready to use. Open the pouch and remove the patch from the protective liner. If you have to undergo surgery whilst using Exelon transdermal patches, tell your doctor that you are using them because they may exaggerate the effects of some muscle relaxants during anaesthesia. Using Exelon with food and drink Food or drink do not affect the use of Exelon transdermal patches because rivastigmine enters the bloodstream through the skin.
Pregnancy and breast feeding Tell your doctor if you are pregnant or planning to become pregnant. If you are pregnant, the benefits of using Exelon transdermal patches must be assessed against the possible effects on your unborn child.
You should not breast-feed during treatment with Exelon transdermal patches. Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines Your doctor will tell you whether your illness allows you to drive vehicles and use machines safely. Exelon transdermal patches may cause fainting or severe confusion. If you feel faint or confused do not drive, use machines or perform any other tasks that require your attention.
How is it used? Always use Exelon transdermal patches exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Only wear one Exelon patch at a time. You must remove the previous day? Do not cut the patch into pieces. How to start treatment Your doctor will tell you which Exelon transdermal patch is most suitable for you.
During the course of the treatment your doctor may adjust the dose to suit your individual needs. Where to apply your Exelon transdermal patch Before you apply a patch, make sure that your skin is: Carefully remove any existing patch before putting on a new one. Having multiple patches on your body could expose you to an excessive amount of this medicine which could be potentially dangerous.
Apply only one patch per day to only one of the following locations, as shown in the following diagrams: Do not apply a new patch to that same location of skin twice within 14 days.
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