Jeffrey Panko NP Psychiatry · Patient education
Rivastigmine
Exelon / Generic capsules, solution, and patches
A guide for adults taking rivastigmine.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Oral capsules or solution are usually taken twice daily with meals. A skin patch is applied once daily. Oral and patch doses are not interchangeable.
What it is used for
Rivastigmine treats dementia symptoms associated with Alzheimer disease or Parkinson disease, depending on formulation and severity. It may support cognition or daily functioning for a time but does not cure the disease.
How it works
It inhibits enzymes that break down acetylcholine, a messenger involved in memory and attention. The same action can affect digestion and heart rate.
What to expect over time
Review benefit over weeks to months with caregiver observations of communication, familiar activities, and care needs. Increasing the dose too quickly can cause severe gastrointestinal effects.
Taking your medication
- For a patch, remove the old one before applying a new one. Use only one patch at a time.
- Apply to clean, dry, intact skin; rotate sites and avoid the same spot for at least 14 days. Do not cut patches or expose them to external heat.
- Do not double an oral dose or add an extra patch after a missed dose.
- After more than three days off, contact your provider before restarting; a low restart dose is needed.
When to get help
Emergency symptoms. Get emergency care for collapse, a very slow pulse with fainting, black or bloody stools, severe allergy, or multiple-patch overdose.
Prompt medical advice. Report persistent vomiting, diarrhea, weight loss, or a patch rash extending beyond the patch or lasting after removal. A widespread or blistering rash needs prompt assessment.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Nausea, vomiting, or diarrhea
- Reduced appetite or weight loss
- Dizziness or falls
- Patch-site redness or irritation
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Track weight, appetite, hydration, pulse-related symptoms, and falls. Check skin reactions and verify daily removal of old patches.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss slow pulse, heart block, fainting, ulcers or bleeding, asthma or COPD, low body weight, and liver disease.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Beta blockers and other heart-rate-lowering medicines can add fainting risk. Anticholinergic medicines may oppose benefit.
Review metoclopramide and other medicines affecting movement. Tell the anesthesia team before surgery.
Everyday tips
Write the application date on the patch or use a caregiver log.
Fold used patches adhesive sides together and keep them away from children and pets.
Your questions answered
What if I find two patches on?
Remove the patches and seek immediate medical advice or Poison Control guidance; too much rivastigmine can be dangerous.
Can I restart the old dose after a break?
Not after more than three days. Contact your provider for a lower restart regimen.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.