Rivastigmine skin patches

What is this medicine?

RIVASTIGMINE (ri va STIG meen) is used to treat mild to moderate dementia caused by Parkinson's disease and mild to severe Alzheimer's disease.

How should I use this medicine?

This medicine is for external use only. Follow the directions on the prescription label. Always remove the old patch before you apply a new one. Apply to skin right after removing the protective liner. Do not cut or trim the patch. Apply to an area of the upper arm, chest, or back that is clean, dry and hairless. Avoid injured, irritated, oily, or calloused areas or where the patch will be rubbed by tight clothing or a waistband. Do not place over an area where lotion, cream, or powder was recently used. Press firmly in place until the edges stick well. To prevent skin irritiation, do not apply to the same place more than once every 14 days. Change your patch at the same time each day. Do not use more often than directed. Do not stop using except on your doctor's advice.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• application site reaction (such as skin redness, blisters, or swelling under or around the patch site)

• changes in vision or balance

• dizziness

• feeling faint or lightheaded, falls

• increase in frequency of passing urine or incontinence

• nervousness, agitation, or increased confusion

• redness, blistering, peeling or loosening of the skin, including inside the mouth

• severe diarrhea

• slow heartbeat or palpitations

• stomach pain

• sweating

• uncontrollable movements

• vomiting

• weight loss

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• headache

• indigestion or heartburn

• loss of appetite

• mild diarrhea, especially when starting treatment

• nausea

What may interact with this medicine?

• antihistamines for allergy, cough, and cold

• atropine

• certain medicines for bladder problems like oxybutynin, tolterodine

• certain medicines for Parkinson's disease like benztropine, trihexyphenidyl

• certain medicines for stomach problems like dicyclomine, hyoscyamine

• glycopyrrolate

• ipratropium

• certain medicines for travel sickness like scopolamine

• medicines that relax your muscles for surgery

• other medicines for Alzheimer's disease

What if I miss a dose?

If you miss a dose, apply a new patch immediately. Then, apply the next patch at the usual time the next day after removing the previous patch. Do not apply 2 patches to make up for the missed one. If treatment is missed for 3 or more days, contact your healthcare provider for further instructions.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Store in original pouch until just prior to use. Throw away any unused medicine after the expiration date. Dispose of used patches properly. Since used patches may still contain active medicine, fold the patch in half so that it sticks to itself prior to disposal.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• application site reaction during previous use of rivastigmine patch

• heart disease

• kidney disease

• liver disease

• lung or breathing disease, like asthma

• seizures

• slow, irregular heartbeat

• stomach or intestine disease, ulcers, or stomach bleeding

• trouble passing urine

• an unusual or allergic reaction to rivastigmine, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Check with your doctor or health care professional if your symptoms do not start to get better or if they get worse.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

Avoid saunas and prolonged exposure to sunlight. You may bathe, swim, shower, or participate in any of your normal activities while wearing this patch. If the patch falls off, apply a new patch for the rest of the day, then replace the patch the next day at the usual time.

If you are going to have a magnetic resonance imaging (MRI) procedure, tell your MRI technician if you have this patch on your body. It must be removed before a MRI.