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Rivastigmine Patches

What is this medication?

RIVASTIGMINE (ri va STIG meen) treats memory loss and confusion (dementia) in people who have Alzheimer or Parkinson disease. It works by improving attention, memory, and the ability to engage in daily activities.

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This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Exelon Patch

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

  • Having surgery
  • Heart disease, slow heartbeat
  • Liver disease
  • Loss of appetite
  • Lung or breathing disease, such as asthma or COPD
  • Seizures
  • Stomach ulcers, other stomach or intestine problems
  • Trouble passing urine
  • An unusual or allergic reaction to rivastigmine, other medications or medication patches, foods, dyes, or preservatives
  • Pregnant or trying to get pregnant
  • Breastfeeding

How should I use this medication?

This medication is for external use only. Use it as directed on the prescription label. Do not apply to burned or damaged skin. Do not use it more often than directed. Keep using it unless your care team tells you to stop.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

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NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, apply a new patch immediately. Apply the next patch at the usual time the next day after removing the previous patch. Do not apply 2 patches to make up for the missed one. If treatment is missed for 3 or more days, talk to your care team for further instructions.

What may interact with this medication?

  • Antihistamines for allergy, cough, and cold
  • Atropine
  • Beta blockers, such as atenolol, metoprolol, propranolol
  • Certain medications for bladder problems, such as oxybutynin or tolterodine
  • Certain medications for Parkinson disease, such as benztropine or trihexyphenidyl
  • Certain medications for stomach problems, such as dicyclomine, hyoscyamine, metoclopramide
  • Certain medications for travel sickness, such as scopolamine
  • Glycopyrrolate
  • Ipratropium
  • Medications that relax your muscles for surgery
  • NSAIDs, medications for pain and inflammation, such as ibuprofen or naproxen
  • Other medications for Alzheimer disease

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.

Heat can increase the amount of medication this patch releases into your body. This can be dangerous. It is important to avoid activities that make your body temperature rise. You can wear this patch during bathing and in hot weather. Do not take hot baths or sunbathe. Avoid hot tubs, saunas, electric blankets, heated waterbeds, or tanning lamps. Do not use a hairdryer or heating pad on or near the area where the patch is applied. Call your care team if you get a fever.

If you are going to need surgery, procedure, or imaging scan (CT or MRI), tell your care team that you are using this medication. You may need to remove the patch before the procedure.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Seizures
  • Slow heartbeat—dizziness, feeling faint or lightheaded, confusion, trouble breathing, unusual weakness or fatigue
  • Uncontrolled and repetitive body movements, muscle stiffness or spasms, tremors or shaking, loss of balance or coordination, restlessness, shuffling walk, which may be signs of extrapyramidal symptoms (EPS)

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Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

  • Diarrhea
  • Irritation at application site
  • Loss of appetite with weight loss
  • Nausea
  • Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep this medication in the sealed pouch until you are ready to use it. Get rid of any unused medication after the expiration date. When you take off a used patch, fold it, so the sticky sides press together. This helps prevent others from contact with medication still in the patch.

To get rid of medications that are no longer needed or have expired:

  • Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
  • If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

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Note: Introduction and Additional Common Questions written and medically approved by Cleveland Clinic professionals.

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