Generic Name: Exelon Brand Name(s): Generics only. No brands available.

Uses

What is Exelon® (rivastigmine) used for?

Exelon® improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical that is important for the processes of memory, thinking, and reasoning. People with dementia usually have lower levels of this chemical.

Exelon® is used to treat mild to moderate dementia caused by Alzheimer’s or Parkinson’s disease.

Exelon® may also be used for purposes not listed in this medication guide.

How should I take Exelon® (rivastigmine)?

Exelon® is usually taken twice per day. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take Exelon® with food.

Exelon® oral solution (liquid) comes with patient instructions for correctly measuring the dose. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

You may swallow the liquid medicine directly from the syringe or mix the medicine with a small glass of water, fruit juice, or soda. Stir the mixture and drink all of it within 4 hours after mixing. To get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

After using the syringe, wipe the outside of it with a clean tissue and put the syringe back into its protective case. Close the medicine bottle using the child resistant closure.

Use Exelon® regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Tell your doctor if you have any changes in weight. Rivastigmine doses are based on weight, and any changes may affect the dose.

If you need surgery, tell the surgeon ahead of time that you are using Exelon®. You may need to stop using the medicine for a short time.

If you stop taking Exelon® for any reason, do not restart the medicine without talking to your doctor first. You may need to restart treatment with a lower dose.

How do I store Exelon® (rivastigmine)?

Exelon® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Exelon® in the bathroom or the freezer. There may be different brands of Exelon® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Exelon® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Exelon® (rivastigmine)?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of Exelon® or other medications.
  • You have any other illnesses, disorders, or medical conditions.

You should not take Exelon® if you are allergic to rivastigmine or similar medicines, such as neostigmine, meprobamate, or carisoprodol.

You should not take oral Exelon® if you have ever had severe redness, itching, or skin irritation caused by wearing Exelon® transdermal skin patch.

To make sure Exelon® is safe for you, tell your doctor if you have:

  • Liver or kidney disease
  • Recent weight loss or lack of appetite
  • A heart rhythm disorder such as “sick sinus syndrome” (slow heartbeats)
  • An enlarged prostate or urination problems
  • Epilepsy or other seizure disorder
  • Asthma, chronic obstructive pulmonary disease (COPD), or other breathing disorder
  • A history of stomach ulcer
  • Tremors (dyskinesia) or uncontrolled muscle movements

Exelon® is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether rivastigmine passes into breast milk or if it could harm a nursing baby. You should not breastfeed while using Exelon®.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Exelon® during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Exelon®. Exelon® is pregnancy risk category B, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from Exelon® (rivastigmine)?

Get emergency medical help if you have signs of an allergic reaction to Exelon®: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • Severe or ongoing vomiting or diarrhea with weight loss
  • Bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds
  • A light-headed feeling, like you might pass out
  • Tremors (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck
  • Seizure (convulsions)
  • Painful or difficult urination
  • Severe skin redness, itching, or irritation
  • If you feel very thirsty or hot, are unable to urinate, and have heavy sweating or hot and dry skin

Common side effects may include:

  • Upset stomach, nausea, vomiting, diarrhea
  • Loss of appetite
  • Weakness

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Exelon® (rivastigmine)?

Exelon® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

  • Atropine
  • Metoclopramide
  • Cold or allergy medicine that contains an antihistamine (Benadryl and others)
  • Medicine to treat Parkinson’s disease
  • Medicine to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome
  • A beta blocker – atenolol, carvedilol, labetalol, metoprolol, nadolol, nebivolol, propranolol, sotalol, and others
  • Bladder or urinary medicines – darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin
  • Bronchodilators – aclidinium, ipratropium, or tiotropium

Does food or alcohol interact with Exelon® (rivastigmine)?

Exelon® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Exelon® (rivastigmine)?

Exelon® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Exelon® (rivastigmine).

What is the dose of Exelon® (rivastigmine) for an adult?

Usual Adult Dose for Alzheimer’s Disease:

Mild to moderate Alzheimer’s Disease:

Oral:

  • Initial dose: 1.5 mg orally twice a day with morning and evening meals.
  • Maintenance dose: After a minimum of two weeks of treatment, if the initial dosage is well tolerated, it may be increased to 3 mg twice a day. Subsequent increases to 4.5 mg and 6 mg twice a day should be attempted only after a minimum of 2 weeks at the previous dosage.

Transdermal:

  • Initial Dose: 4.6 mg/24 hour transdermal patch applied to the skin once daily
  • Maintenance Dose: After a minimum of four weeks of treatment and if well tolerated, the dose of the patch can be increased to 9.5 mg/24 hours for as long as this dose is beneficial. The dose can then be increased to 13.3 mg/24 hours.
  • Maximum Dose: 13.3 mg/ 24 hour transdermal patch applied to skin daily. Higher doses confer no appreciable additional benefit, and are associated with significant increase in the incidence of adverse events.

Severe Alzheimer’s Disease:

13.3 mg/24 hours transdermal patch applied to skin once daily; replace with a new patch every 24 hours.

Usual Adult Dose for Parkinson’s Disease:

Mild to Moderate Parkinson’s Disease Dementia:

Oral:

  • Initial dose: 1.5 mg orally twice a day with morning and evening meals
  • Maintenance dose: Subsequently, the dose may be increased to 3 mg orally twice a day and further to 4.5 mg twice a day and 6 mg twice a day (based on tolerability) with a minimum of 4 weeks at each dose.

Transdermal:

  • Initial dose: 4.6 mg/24 hours applied to the skin once a day
  • Maintenance dose: After a minimum of four weeks of treatment and if well tolerated, the dose of the patch be increased to 9.5 mg/24 hours for as long as this dose is beneficial. The dose can then be increased to 13.3 mg/24 hours.
  • Maximum dose: 13.3 mg/ 24 hours. Higher doses confer no appreciable additional benefit, and are associated with significant increase in the incidence of adverse events.

What is the dose of Exelon® (rivastigmine) for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Exelon® (rivastigmine) available?

Exelon® is available in the following dosage forms and strengths:

  • Capsules and oral solution: rivastigmine tartrate 1.5mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Exelon®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 14, 2017 | Last Modified: August 14, 2017

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