Exelon

Generic Name: Rivastigmine

  • What is Exelon?

    Exelon is used to treat mild-to-moderate dementia (memory loss) in Alzheimer's disease and Parkinson's disease patients.

  • What is the most important information I should know about Exelon?

    Exelon may cause you to feel significant stomach upset such as nausea (feeling sick), vomiting, and decreased appetite. This is more likely to occur if you are taking Exelon capsules or oral solution. It is less likely to occur if you are using the Exelon patch.

    Exelon may cause you to lose weight which may be due to the stomach upset with which Exelon is associated.

    Your doctor and caregiver should monitor for stomach upset, nausea, vomiting, decreased appetite, and weightloss. It is important to tell your doctor and caregiver if you do not take Exelon for more than several days. Do not take the next dose until you talk to your doctor.

    All forms of Exelon (capsules, oral solution, or patches) may cause diarrhea, increase your chances of developing a seizure, and may cause or worsen extrapyramidal symptoms such as tremor. Extrapyramidal symptoms are usually persistent movement disorders or muscle disturbances, such as restlessness, tremors, and muscle stiffness. If you observe any of these symptoms, talk to your doctor.

    Tell your doctor if you are scheduled to have surgery while using Exelon because it may exaggerate muscle-relaxing effects during anesthesia.

    Your doctor will tell you whether your illness allows you to drive and use machines safely. Exelon Patch may cause dizziness and drowsiness, mainly at the start of treatment or when increasing the dose. If you feel dizzy or drowsy, do not drive, use machines or perform any other tasks that require your attention.

    Tell your doctor if you experience any of these side effects with the Exelon patch: depression, severe confusion, hallucinations, vascular accident involving the brain (loss of coordination, difficulty in speaking or breathing and signs of brain disorder), fainting, problems with heart rhythm (irregular or fast or slow heartbeat), gastric ulcer and gastrointestinal hemorrhage (blood in stools or when vomiting). If you experience severe agitation, drowsiness, sweating and a general feeling of being unwell, call your doctor.

    You may tend to see side effects more frequently when you start your medication or increase to a higher dose. In most cases, side effects will gradually disappear as your body becomes used to the medicine.

  • Who should not take Exelon?

    Do not take Exelon if you are allergic to Exelon or to any of its ingredients.

    The Exelon patch is not recommended for use in children.

  • What should I tell my doctor before I take the first dose of Exelon?

    Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Exelon. Also, talk to your doctor about your complete medical history before beginning treatment with Exelon, especially if you have or had a history of stomach ulcers, stomach bleeding, active stomach ulcer, heart problems (e.g., irregular heartbeats), difficulties in passing urine, seizures, breathing or lung problems (e.g., asthma, severe respiratory disease), kidney problems, smoking cigarettes or other tobacco products, low body weight, trembling, liver problems, are taking nonsteroidal anti-inflammatory drugs (NSAIDs), scheduled for surgery or anesthesia, are pregnant, might be pregnant, plan to become pregnant, are breastfeeding or plan to breastfeed.

  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

    Dementia in Alzheimer's disease

    The usual dosage of Exelon for dementia in Alzheimer's patients is 3 to 6 milligrams (mg) taken twice a day if given in the oral solution or tablet form. Doses may be increased at a minimum of two-week intervals with a maximum of 12 mg per day.

    Your doctor will tell you which Exelon patch is suitable for you. Treatment usually starts with Exelon patch 4.6 mg that is worn for 24 hours, and after several weeks many patients move to Exelon patch 9.5 mg that is worn for 24 hours as the usual daily dose. Apply the correct dose as directed by your doctor. The patch should be replaced by a new one after 24 hours. During the course of treatment, your doctor may adjust the dose to suit your individual needs.

    If you cannot tolerate side effects (e.g., nausea, vomiting, diarrhea, loss of appetite), your doctor may recommend discontinuing treatment for several days and then restarting at the same or next lower dose.

    Dementia in Parkinson's disease

    The recommended starting dose of Exelon for dementia in Parkinson's patients is 1.5 mg twice daily if given in the oral solution or tablet form. The usual dosage range is 1.5 mg to 6 mg taken twice a day. Doses may be increased at a minimum of 4-week intervals with a maximum of 12 mg per day.

    Your doctor will tell you which Exelon patch is suitable for you. Treatment usually starts with Exelon patch 4.6 mg that is worn for 24 hours, and after several weeks many patients move to Exelon patch 9.5 mg that is worn for 24 hours as the usual daily dose. Apply the correct dose as directed by your doctor. The patch should be replaced by a new one after 24 hours. During the course of treatment, your doctor may adjust the dose to suit your individual needs.

    If you cannot tolerate side effects (e.g., nausea, vomiting, diarrhea, loss of appetite), your doctor may recommend discontinuing treatment for several days and then restarting at the same or next lower dose.

  • How should I take Exelon?

    Exelon capsules and oral solution should be taken with meals in the morning and the evening. Exelon oral solution may be taken straight, or may be mixed with a small glass of water, cold fruit juice, or soda.

    The oral solution and capsules may be used interchangeably as long as the dosage remains the same.

    If you are using the Exelon patch, it should be applied to the upper or lower back or to the upper arm or chest area.

    If you are a caretaker and feel that the patient will pull the patch off before he or she is supposed to, place the Exelon patch on the patient's back. Avoid placing the patch in an area where it can be rubbed off by tight clothing. Before applying the patch, make sure the area where you are applying is clean, dry, and hairless, free of any powder, oil, moisturizer, or lotion, and free of cuts, rashes, or irritations.

    The Exelon patch should be worn for 24 hours. After 24 hours, remove the patch and apply a new patch to a different spot of skin. Do not apply a new patch to a previously used spot for at least 14 days.

  • What should I avoid while taking Exelon?

    Your doctor will tell you whether your illness allows you to drive and use machines safely. Exelon may cause dizziness and drowsiness, mainly at the start of treatment or when increasing the dose. If you feel dizzy or drowsy, do not drive, use machines or perform any other tasks that require your attention.

    Avoid missing doses of Exelon for more than several days. Contact your doctor and do not restart Exelon before talking to your doctor.

    Avoid becoming pregnant or breastfeeding while on Exelon.

    Do not eat Exelon patch. You must remove Exelon patch from the previous day before applying a new one. Avoid placing the patch where it could be rubbed off by clothing.

    Do not use any Exelon patch that is damaged or shows signs of tampering. Do not cut the patch into pieces. Keep Exelon patch out of reach and sight of children and pets.

  • What are possible food and drug interactions associated with Exelon?

    If Exelon is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Exelon with anticholinergic medications, cholinesterase inhibitors (drugs that are in the same class as Exelon) such as succinylcholine, other cholinomimetic drugs, similar neuromuscular blocking agents or cholinergic agonists (such as bethanechol), and tobacco products.

    For the Exelon patch, food or drink does not affect the Exelon patch because the drug enters your bloodstream through your skin.

  • What are the possible side effects of Exelon?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects for Exelon Capsules and Solution may include: convulsions, severe confusion, hallucinations, vascular accident involving the brain (loss of coordination, difficulty in speaking or breathing and signs of brain disorder), depression, inflammation of the pancreas (severe upper stomach pain, often with nausea and vomiting), vomiting (being sick), severe vomiting that can lead to a rupture of the esophagus, chest pain, duodenal ulcer, fainting, problems with heart rhythm (irregular or fast or slow heartbeat), gastric ulcer, gastrointestinal hemorrhage (blood in stools or when vomiting), accidental falls, changes in liver function tests, urinary tract infection, agitation, drowsiness, sweating and a general feeling of being unwell, stomach upset, nausea (feeling sick), loss of appetite, weight loss, high blood pressure, confusion, trembling, anxiety, difficulty sleeping, dizziness, headache, diarrhea, stomach discomfort after meals, stomach pain, skin reactions at the application site (redness, itching, irritation, swelling), fatigue, weakness, rash

    Side effects for Exelon Patch may include: severe confusion, hallucinations, vascular accident involving the brain (loss of coordination, difficulty in speaking or breathing and signs of brain disorder), depression, fainting, problems with heart rhythm (irregular or fast or slow heartbeat), gastric ulcer, gastrointestinal hemorrhage (blood in stools or when vomiting), agitation, drowsiness, sweating and a general feeling of being unwell, stomach upset, nausea (feeling sick), vomiting (being sick), loss of appetite, anxiety, difficulty sleeping, dizziness, headache, diarrhea, stomach discomfort after meals, stomach pain, skin reactions at the application site (redness, itching, irritation, swelling), fatigue, weakness, weight loss

  • Can I receive Exelon if I am pregnant or breastfeeding?

    The effects of Exelon during pregnancy and breastfeeding are unknown. Talk with your doctor before taking this drug if you are pregnant, may be pregnant, plan to become pregnant, or are breastfeeding.

  • What should I do if I miss a dose of Exelon?

    If you miss taking a dose of Exelon tablets or oral solution, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule. Do not take a double dose. It is important to tell your doctor and caregiver if you do not take Exelon for more than several days. Do not take the next dose before you talk to your doctor.

    If you have forgotten to apply Exelon patch, apply a new patch immediately. You may apply the next patch at the usual time the next day. Do not apply two Exelon patches to make up for the one that you missed. If you have not been applying Exelon patch for several days, do not apply the next patch before you have talked to your doctor.

  • How should I store Exelon?

    Store the Exelon capsules at room temperature in a tight container. Exelon oral solution can also be stored at room temperature, in an upright position and protected from freezing. If Exelon oral solution is combined with cold fruit juice or soda, the mixture may be stored at room temperature for four hours.

    Store Exelon patches at room temperature. Do not use Exelon patches beyond the expiration date that is listed on the carton and pouch. Do not use any Exelon patch that is damaged or shows signs of tampering. Keep Exelon patch out of reach and sight of children and pets.

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