Monograph Details
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Central Nervous System
> Alzheimer's dementia
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EXELON PATCH |
| Manufacturer |
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Novartis Pharmaceuticals Corp |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Reversible acetylcholinesterase inhibitor (carbamate deriv). |
| Generic Name |
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Rivastigmine 4.6mg/24hours, 9.5mg/24hours; transdermal system. |
| Also |
• EXELON
• EXELON ORAL SOLUTION
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| Indications |
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Mild to moderate dementia of the Alzheimer's type. |
| Children |
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Not applicable. |
| Adults |
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Take with food in the AM and PM. Soln: may give directly from syringe or mix with water, fruit juice, or soda. Caps and soln may be interchanged at equal doses. Initially 1.5mg twice daily; if well-tolerated, may increase by 1.5mg twice daily at intervals of at least 2 weeks. Usual range: 6–12mg/day; max 12mg/day. If dose is not tolerated, suspend for several doses and restart at same or next lower dose. If stopped for more than several days restart at 1.5mg twice daily and retitrate. Patch: Apply to clean, dry, hairless intact skin. Rotate application site (allow 14 days before reapplying to same site). Initially apply one 4.6mg/24hours patch; if tolerated, may increase to 9.5mg/24hours patch after 4 weeks at previous dose. Low body wt. (<50kg): monitor dose adjustments. Switching from capsules or oral solution: see literature. |
| Precautions |
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Monitor for nausea, vomiting, anorexia, weight loss, GI bleed. Sick sinus syndrome, other supraventricular conduction disturbances. Seizures. History or risk of ulcers. Urinary obstruction. Asthma. COPD. Pregnancy (Cat.B). Nursing mothers: not recommended. |
| Interactions |
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Antagonizes anticholinergics. May potentiate succinylcholine-type muscle relaxants, other cholinesterase inhibitors, cholinergic agonists. Monitor for GI bleed with NSAIDs. |
| Adverse Reactions |
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GI upset, dyspepsia, abdominal pain, dizziness, anorexia, weight loss, headache, fatigue, insomnia, asthenia, malaise, tremor, syncope, hyperhidrosis, cholinergic effects. |
| How Supplied |
Caps—60, 500
Soln—120mL (w. dosing syringe)
Patches—30 |
| Additional Resources |
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• Related Prescribing Note |
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