Exelon Patch (Rivastigmine)

(℞) Prescription Required

    Exelon Patch (Rivastigmine) Dosage and Side Effects

    EXELON is used to treat dementia.  Dementia describes a group of symptoms, such as a decline in thinking ability and memory, caused by a brain disorder such as Alzheimer's disease. Oral forms of the drug (capsule and solution) treat the mild to moderate dementia of Alzheimer's or Parkinson's disease. A transdermal patch that delivers the drug through the skin treats these issues as well as severe dementia caused by Alzheimer's disease.

    Warnings and Precautions

    BEFORE you use EXELON talk to your doctor or pharmacist if:

    • you have, or ever had irregular heartbeat;

    • you have, or ever had asthma or a severe respiratory disease;

    • you have, or ever had seizures (fits or convulsions);

    • you have a history of stomach ulcers or have an increased risk of developing ulcers (for example you are taking non-steroidal anti-inflammatory drugs (NSAIDS) or high doses of acetylsalicylic acid [ASA];

    • you have a low body weight (less than 50 kg);

    • you have, or ever had difficulties in passing urine;

    • you have, or ever had liver or kidney problems;

    • you have, or ever had inflammation of the pancreas;

    • you are pregnant, planning on becoming pregnant, or breast feeding.

    • you suffer from trembling;

    • you have fainting episodes;

    • you experience gastro-intestinal reactions such as severe nausea (feeling sick), vomiting (being sick) and diarrhea. You may become dehydrated (losing too much fluid) if vomiting or diarrhea are prolonged.

    Talk to your doctor right away if you have skin inflammation, blisters or swelling of the skin that are increasing and spreading.

    Your doctor will determine whether you can take EXELON and how closely you will need to be monitored while you are on this medicine.

    Can I drive vehicles and operate machinery?

    Your doctor will tell you whether your illness allows you to drive vehicles and operate machinery safely. If you feel dizzy or drowsy, do not drive, use machines or perform any other tasks that require your attention.

    Side Effects

    As with all medicines, patients taking EXELON may experience side effects, although not everybody gets them.

    In clinical studies most side effects of EXELON were of mild to moderate intensity.

    The most common side effects (affect between 1 and 10 in every 100 patients) noted were:

    • feeling sick (nausea), being sick (vomiting), diarrhea, stomach discomfort after meal, stomach pains and loss of appetite;

    • dizziness, headache, sleepiness, drowsiness, trembling;

    • agitation, confusion, anxiety;

    • weakness, fatigue, a general feeling of being unwell;

    • sweating;

    • weight loss.

    Other common side effects reported with EXELON are:

    • muscle stiffness, difficulty in carrying out movements, uncontrollable movement of mouth, tongue and limbs, abnormally decreased muscular movement (worsening of Parkinson’s disease symptoms),

    • irritation, reddening, rashes, itching (skin reactions),

    • losing too much fluid (dehydration),

    • restlessness,

    • too much saliva,

    • abnormal way of walking,

    • light-headedness due to low blood pressure,

    • high blood pressure.

    These side effects will most probably disappear gradually as your body becomes used to the medicine or with a reduction in dose. If they persist, however, you should tell your doctor.

    Uncommon side effects (affect between 1 and 10 in every 1000 patients):

    • difficulty in sleeping,

    • change in blood test results related to liver function,

    • accidental falls,

    • abnormal posture with poor control of movements,

    • inability to adequately retain urine (urinary incontinence).

    Very rare side effects (affect less than 1 in 10 000 patients):

    • blister.

    Additional side effects reported with EXELON at an unknown frequency:

    • aggression,

    • alternating heart rhythms (heart disorders),

    • skin inflammation, blisters or swelling of the skin that are increasing and spreading.

    If you feel unwell in this or any other way or have any symptoms that you do not understand, or find distressing, you should contact your doctor immediately. Tell your doctor if any side effects become severe or troublesome to you. If you experience severe adverse events and cannot contact your doctor, stop taking the drug until you can discuss your symptoms with your doctor.

    Interactions with this medication

    Make sure your doctor knows if you are taking, have recently taken, or begin to take, any other medicines, including drugs, or herbal (natural) products that you can buy without a prescription.
     
    EXELON should not be given at the same time as other medicines with similar effects (cholinomimetic agents) or with anticholinergic medicines (e.g. medicines used to relieve stomach cramps or spasms, or to treat Parkinson's disease or to prevent travel sickness).
     

    EXELON should not be given together with metoclopramide (a medicine used to alleviate or prevent nausea and vomiting). There may be additive effects such as stiff limbs and trembling hands.

    Your doctor will tell you if you can also take EXELON with your current medications. If you have to undergo surgery while taking EXELON, you should inform the doctor before you are given any anaesthetics (drugs that produce a loss of sensation).

    Caution when EXELON is taken together with beta-blockers (medicines such as atenolol used to treat hypertension, angina, and other heart conditions). There may be additive effects such as bradycardia (slow heartbeat) that may result in syncope (fainting, loss of consciousness).

    Proper Use of this medication

    This medicine has been prescribed only for you. It must not be given to anybody else or used for any other illnesses.

    EXELON should be taken with food.

    Capsules:

    Swallow the capsules whole with a drink, without opening or crushing them.

    Oral solution:

    Remove the oral dosing syringe provided from its protective case. Using the syringe, withdraw the prescribed amount of EXELON oral solution from the container. Each dose of EXELON oral solution may be swallowed directly from the syringe or first mixed with a small glass of water, cold fruit juice or soda. Stir and drink the entire mixture.

    1. Remove oral dosing syringe from its protective case. Push down and twist child resistant closure to open bottle.

    2. Insert tip of syringe into opening of white stopper.

    3. While holding the syringe, pull the plunger tip to the level (see markings on side of syringe) that equals the dose prescribed by your doctor.

    4. Before removing syringe containing prescribed dose from bottle, push out large bubbles by moving plunger up and down a few times. After the large bubbles are gone, pull the plunger again to the level that equals the dose prescribed by your doctor. Do not worry about a few tiny bubbles. This will not affect your dose in any way. Remove the syringe from the bottle.

    5. You may swallow EXELON Oral Solution directly from the syringe or mix with a small glass of water, cold fruit juice or soda; be sure to stir completely and to drink the entire mixture right away. DO NOT MIX WITH OTHER LIQUIDS.

    6. After use, wipe outside of syringe with a clean tissue and put it back in its case. Close bottle using child resistant closure.

    Usual dose:

    You must take EXELON twice a day, once with your breakfast and once with your evening meal. Taking EXELON at the same time each day will help you remember when to take your medicine.

    Your doctor will tell you what dosage of EXELON to take, starting with a low dose and gradually increasing, depending on how you respond to the treatment. The highest dose that should be taken is 6 mg twice a day (12 mg/day).

    To benefit from your medicine you must take it every day. If you have questions about how long to take EXELON, talk to your doctor or your pharmacist.

    Overdose:

    If you have taken more medication than what has been prescribed, contact either a hospital emergency department, the nearest Poison Control Centre or your doctor immediately. You may require medical attention even if there are no symptoms.

    • Some people who have accidentally taken too much oral EXELON have experienced nausea (feeling sick), vomiting (being sick), and diarrhea. You may become dehydrated (losing too much fluid) if vomiting or diarrhea are prolonged.

    • Some people may also experience high blood pressure, hallucinations, slow heart beat and fainting.

    Missed dose:

    If you find you have forgotten to take your dose of EXELON, do not worry, wait and take the next dose at the usual time. Do NOT take two doses at once.

    Do not stop taking EXELON or change your dose without talking with your doctor.

    If you stop taking EXELON for more than three days, do NOT begin to take EXELON again without contacting your doctor.

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    The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.