What is the most important information I should know about rivastigmine transdermal?

You should not use this medication if you are allergic to rivastigmine or similar medications such as felbamate (Felbatol), carisoprodol (Soma, Vanadom), or meprobamate (Equanil, Miltown).

Before using rivastigmine, tell your doctor if you have liver disease, a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats), recent weight loss or lack of appetite, an enlarged prostate, urination problems, a seizure disorder, asthma or allergies, tremors or uncontrolled muscle movements, or a history of stomach ulcer.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Always remove an old patch before putting on a new one. Do not wear more than 1 patch at a time.

Call your doctor at once if you have severe or ongoing vomiting or diarrhea, loss of appetite, weight loss, heavy sweating or hot and dry skin, black or bloody stools, coughing up blood, tremors (uncontrolled shaking), or restless muscle movements in your eyes, tongue, jaw, or neck.

If you stop using rivastigmine for any reason, do not restart the medication without talking to your doctor first. You may need to restart treatment with a lower dose. Call your doctor for instructions if you forget to change your patch for more than 3 days in a row.

If you need surgery, tell the surgeon ahead of time that you are using rivastigmine transdermal.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What is rivastigmine transdermal?

Rivastigmine improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.

Rivastigmine transdermal (skin patch) is used to treat mild to moderate dementia caused by Alzheimer's or Parkinson's disease.

Rivastigmine transdermal may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using rivastigmine transdermal?

You should not use this medication if you are allergic to rivastigmine or similar medications such as felbamate (Felbatol), carisoprodol (Soma, Vanadom), or meprobamate (Equanil, Miltown).

To make sure this medication is safe for you, tell your doctor if you have any of these other conditions:

• liver or kidney disease;
• recent weight loss or lack of appetite;
• a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats);
• an enlarged prostate or urination problems;
• epilepsy or other seizure disorder;
• asthma or other breathng disorder;
• a history of stomach ulcer; or
• tremors (dyskinesia) or uncontrolled muscle movements.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Rivastigmine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medication.

How should I use rivastigmine transdermal?

Use exactly as prescribed by your doctor. Do not apply more patches or use them for longer than recommended. Your doctor may occasionally change your dose to make sure you get the best results. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Never cut or tear a rivastigmine patch.

Apply the patch to a flat and hairless area of your chest, upper or lower back, or the outer part of your upper arm. Press the patch firmly into place for about 10 seconds to make sure it sticks. You may leave the patch on while bathing, showering, or swimming.

If a patch falls off, apply a new patch and wear it for the rest of the day. Change the patch at your usual time the next day.

Remove the skin patch after 24 hours and replace it with a new one.

Always remove an old patch before putting on a new one. Do not wear more than 1 patch at a time.

Choose a different place on your body to wear the patch each time you put on a new one. Do not use the same skin area twice within 14 days.

Avoid placing the patch where it will be rubbed by tight clothing, or in the folds of your skin. The patch should remain flat on the skin at all times. Take care to avoid accidentally removing the patch while showering or during physical activity.

Do not wear more than one rivastigmine patch at a time. Using extra skin patches will not make the medication more effective. Never cut a skin patch.

Always wash your hands after removing the patch.

After removing a patch, fold it in half so it sticks together and throw it away in a place where children or pets cannot get to it.

It may take up to 4 weeks before your symptoms improve. For best results, keep using the patches as directed.

If you need surgery, tell the surgeon ahead of time that you are using rivastigmine transdermal. You may need to stop using the medicine for a short time.

If you stop using rivastigmine transdermal for any reason, do not restart the medication without talking to your doctor first. You may need to restart treatment with a lower dose.

Store at room temperature away from moisture and heat. Keep each patch in its foil pouch until you are ready to use it.

What happens if I miss a dose?

If you forget to change the skin patch, remove it and apply a new one as soon as you remember. Do not wear extra patches to make up a missed dose.

Call your doctor for instructions if you miss more than 3 doses of rivastigmine.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid while using rivastigmine transdermal?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Do not use any cream, lotion, ointment, oil, or powder on the skin where you plan to apply a skin patch. The patch may not stick well to the skin.

Avoid applying heat to the skin where the patch is worn, because it may increase the amount of medicine your body absorbs. Heat sources include hot tubs, heating pads, heat lamps, saunas, heated water beds, and direct sunlight.

Avoid touching your eyes after handling a skin patch.

What are the possible side effects of rivastigmine transdermal?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• feeling like you might pass out;
• severe or ongoing vomiting or diarrhea, loss of appetite, weight loss;
• feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;
• black or bloody stools, coughing up blood or vomit that looks like blood or coffee grounds;
• restless muscle movements in your eyes, tongue, jaw, or neck;
• tremors (uncontrolled shaking);
• seizure (convulsions); or
• pain or burning when you urinate.

Less serious side effects may include:

• headache, tired feeling;
• dizziness, spinning feeling;
• anxiety, depressed mood;
• mild nausea or stomach pain;
• muscle weakness;
• sleep problems (insomnia); or
• redness or irritation where the skin patch is worn.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect rivastigmine transdermal?

Do not take rivastigmine capsules or oral liquid at the same time you are wearing the skin patch.

Tell your doctor about all other medicines you use, especially:

• atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm Scop);
• bladder or urinary medicines such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);
• bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);
• cold or allergy medicine that contains an antihistamine;
• irritable bowel medicines such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, HyoMax, Levsin, and others), or propantheline (Pro Banthine);
• ulcer medications such as clidinium (Quarzan), glycopyrrolate (Robinul) or mepenzolate (Cantil);
• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others; or
• medicines used to treat Parkinson's Disease such as levodopa (Dopar, Larodopa, Sinemet, Atamet, others), bromocriptine (Parlodel, others), pergolide (Permax), pramipexole (Mirapex), or ropinirole (Requip).

This list is not complete and other drugs may interact with rivastigmine transdermal. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about rivastigmine transdermal.