Exelon

Generic name: Rivastigmine tartrate

What is Exelon?

Exelon is used to treat mild-to-moderate dementia 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 develop significant gastrointestinal adverse reactions such as nausea, 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 experience weight loss which may be attributed to the gastrointestinal effects with which Exelon is associated.

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.

Who should not take Exelon?

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

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 a history of stomach ulcers, heart problems, breathing or lung problems, and are taking nonsteroidal anti-inflammatory drugs (NSAIDs).

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 3-6 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.

If Exelon is given as a patch, then initially the 4.6 milligram (mg) patch should be worn for 24 hours. After 4 weeks of treatment, and if you do not experience any significant side effects (nausea, vomiting, diarrhea, loss of appetite), the patch strength may be increased to the 9.5 milligram (mg) patch and it should be worn for 24 hours and then replaced with a new patch.

Dementia in Parkinson's disease

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

If Exelon is given as a patch, then initially the 4.6 milligrams (mg) patch should be worn for 24 hours. After 4 weeks of treatment, and if you do not experience any significant side effects (eg, nausea, vomiting, diarrhea, loss of appetite), the patch strength may be increased to the 9.5 milligram (mg) patch. It should be worn for 24 hours and then replaced with a new patch.

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?

Exelon may cause you to develop neurological effects (eg, seizures). Therefore, avoid participating in potentially hazardous activities (eg, driving, operating machinery) unless your physician has told you otherwise.

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, succinylcholine, other cholinomimetic drugs, and similar neuromuscular blocking agents or cholinergic agonists (such as bethanechol).

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: anxiety, confusion, constipation, depression, dizziness, diarrhea, fatigue, feeling of uneasiness or out of sorts, hallucinations, headache, flu-like symptoms, increased blood pressure, increased sweating, indigestion, insomnia, intestinal gas, loss of appetite, loss of consciousness or fainting, nausea, stomach pain, tremor, urinary tract infection, vomiting, weight loss, weakness, worsening symptoms if you have Parkinson's disease

Side effects for Exelon Patch may include: anxiety, diarrhea, dizziness, depression, headache, indigestion, insomnia, loss of appetite, nausea, skin irritation at the site of patch application, stomach pain, vomiting, 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, 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.

If you miss applying the Exelon patch, apply it as soon as you remember. Then apply the next patch at the usual time you take your dose. Do not apply two patches at once to make up for the missed dose.

If you have missed taking Exelon for several days, contact your physician before restarting therapy with Exelon.

How should I store Exelon?

Store the Exelon capsules at room temperature and 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.