Alzheimer’s Medications: Comparing Your Treatment Options
Alzheimer’s-related dementia can be treated with oral, topical, and IV medications. Learn about the best treatments for Alzheimer’s, including side effects.
rivastigmine
Used for Alzheimer's Disease, Parkinson's Disease
Used for Alzheimer's Disease, Parkinson's Disease
The rivastigmine patch, also known by its brand name Exelon, is an acetylcholinesterase inhibitor. It's approved for adults to help with symptoms of dementia related to Alzheimer's disease or Parkinson's disease. The rivastigmine patch (Exelon) is applied onto the skin once per day. The dosage typically depends on your response to the medication and your risk for side effects. Common side effects include nausea, vomiting, and diarrhea.
What is Rivastigmine patch (Exelon)?
What is Rivastigmine patch (Exelon) used for?
- Dementia related to Alzheimer's disease or Parkinson's disease
How Rivastigmine patch (Exelon) works
The rivastigmine patch (Exelon) is an acetylcholinesterase inhibitor. It's not completely known how the medication helps treat dementia. But it's thought to work by blocking a protein called cholinesterase. It causes a natural chemical called acetylcholine to stick around in your brain longer. This helps your brain cells communicate with each other better, which is important for memory, attention, and thinking skills.
Drug facts
| Common Brands | Exelon |
|---|---|
| Drug Class | Acetylcholinesterase inhibitor |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Rivastigmine patch (Exelon) essentials
Side effects of Rivastigmine patch (Exelon)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea (7%)
- Vomiting (6%)
- Diarrhea (6%)
Less Common Side Effects
- Stomach pain
- Loss of appetite
- Weight loss
- Headache
- Dizziness
- Tiredness
- Weakness
- Depression
- Anxiety
- Trouble sleeping
- Urinary tract infection (UTI)
Rivastigmine patch (Exelon) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Allergic skin reaction: rash, skin redness, swelling, blisters
- Too much medication in the body: severe nausea, vomiting, diarrhea, stomach cramps, blurry vision, trouble breathing
More on Rivastigmine patch (Exelon) side effects
The following Rivastigmine patch (Exelon) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Bladder pain
bloody or cloudy urine
difficult, burning, or painful urination
frequent urge to urinate
lower back or side pain
Less common
Blurred vision
dizziness
headache
loss of bladder control
nervousness
pounding in the ears
slow or fast heartbeat
Rare
Abdominal or stomach pain or tenderness
arm, back, or jaw pain
chest pain, tightness, heaviness, or discomfort
confusion
convulsions
decreased urine
difficult or troubled breathing
dilated neck veins
extreme fatigue
false beliefs that cannot be changed by facts
irregular breathing
irregular heartbeat
loss of consciousness
rapid breathing
seizures
severe nausea or vomiting
shortness of breath
sunken eyes
swelling of the face, fingers, feet, or lower legs
wrinkled skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Blurred vision
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
increasing muscle weakness
irregular, fast or slow, or shallow breathing
pale or blue lips, fingernails, or skin
slow or irregular heartbeat
sweating
unusual tiredness or weakness
watering of mouth
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
discouragement
fear
feeling of constant movement of self or surroundings
feeling sad or empty
irritability
lack of appetite
lack or loss of strength
loss of interest or pleasure
redness at the application site
sensation of spinning
stomach pain
tiredness
trouble concentrating
trouble sleeping
upper stomach pain
vomiting
Rare
Blindness
burning, stinging, or pain at application site
continuing ringing or buzzing or other unexplained noise in the ears
decreased vision
difficulty with moving
hearing loss
itchy skin
muscle pain or stiffness
pain in the joints
pale skin
tearing
troubled breathing with exertion
unusual bleeding or bruising
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
$183.53
GoodRx discount
$23.79
Pros and cons of Rivastigmine patch (Exelon)
Pros
- A treatment option for dementia related to Alzheimer's or Parkinson's
- A patch that's applied directly to the skin once per day
- Less common to cause side effects than rivastigmine capsules
Cons
- Doesn't cure dementia
- Can cause skin irritation where the patch gets applied
- Can worsen the symptoms of other medical conditions (e.g., lung problems, stomach ulcers, trouble urinating)
Pharmacist tips for Rivastigmine patch (Exelon)
- Apply the rivastigmine patch (Exelon) once per day onto clean, dry, and hairless skin. Place the patch on the left or right upper arm or the left or right side of the chest, upper back, or lower back. Choose a different area of skin for each patch to prevent skin irritation; don't use the same spot within 14 days.
- Only wear 1 rivastigmine patch (Exelon) at a time. Change the patch every 24 hours. Remember to take the old patch off before putting a new one on.
- Rivastigmine patch (Exelon) commonly causes upset stomach. Your care team can suggest tips and tricks to help prevent or ease this side effect. But contact your prescriber if stomach upset becomes too bothersome.
- The rivastigmine patch (Exelon) can sometimes make people dizzy or tired. This can affect the ability to concentrate, think, and react. Avoid activities that require focus, such as driving a car or operating machinery, until you know how this medication affects you.
- To apply the patch: Remove the patch from its pouch. Peel off one side of the adhesive liner and stick the patch to the skin. Then, peel off the other side of the liner. Press down on the patch firmly for 30 seconds and make sure the edges are smoothed down. Save the pouch for when you need to remove the patch.
- To remove the patch: Gently pull on one edge of the patch to take it off. Then, fold the patch in half so the sticky sides are together. Put the folded patch back in the pouch that you saved, and throw it away in the trash.
- Wash your hands well with soap and water right away after applying or removing a rivastigmine patch (Exelon), especially if you accidentally touched the sticky side of the patch (either a new or used one). The sticky side of the patch contains medication. Don't use hand sanitizer or alcohol-based cleansers.
- You can shower, bathe, or swim with the rivastigmine patch (Exelon) on, but be sure to check whether the patch becomes loose afterwards.
- Avoid heat sources, such as saunas, heating blankets, or hot tubs, while you're wearing the rivastigmine patch (Exelon). The heat can cause too much medication to get released from the patch, which can raise your risk for serious side effects like severe vomiting and trouble breathing.
- If the patch falls off before you need to replace it: Put on a new patch right away. Then, replace the patch the next day when you typically do (at the same time as you normally would). Don't use any bandages or tape to stick a loose patch back on. Also don't try to stick back on the same patch.
- If you forget to change your patch: Put a new patch on as soon as you remember. Then, go back to your regular schedule to change the patch. It's okay if you wear a patch for less than 24 hours. Don't apply 2 patches to make up for this missed dose.
- If you forget to wear a rivastigmine patch (Exelon) for more than 3 days in a row: Contact your prescriber about restarting the medication. You might need to restart at a lower dose to avoid side effects.
Risks and warnings for Rivastigmine patch (Exelon)
Rivastigmine patch (Exelon) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Stomach upset and loss of appetite
- Risk factors: Taking higher doses of rivastigmine patch (Exelon)
Even though the rivastigmine patch (Exelon) is placed on the skin, it can cause stomach-related side effects, such as nausea, vomiting, diarrhea, and a loss of appetite. Severe or long-lasting side effects could potentially lead to dehydration and some weight loss. Stomach-related side effects are more likely to happen if you take higher doses of the patch or if your dose gets raised too quickly.
Always use the rivastigmine patch (Exelon) exactly as prescribed. If you miss more than 3 days of the medication, contact your prescriber. They might tell you to restart at a lower dose to avoid these side effects.
Skin reactions
You might have skin irritation where you apply the rivastigmine patch (Exelon). This irritation typically improves within 48 hours of removing the patch.
But look out for skin reactions that spread further than the patch size; worsening redness, swelling, or blisters on the skin; or skin reactions that don't go away after a few days of removing the patch. These can be signs of an allergic skin reaction. Contact your prescriber right away if you have these symptoms so they can discuss with you about your options.
Other side effects from rivastigmine patch (Exelon)
- Risk factors: Movement problems | Seizures | Stomach bleeding or peptic ulcers | Heart rate or heart rhythm problems | Problems with urination | Breathing problems
Rivastigmine patch (Exelon) raises the levels of acetylcholine in your body, which can affect other functions of the body and cause other side effects.
For example, rivastigmine patch (Exelon) can cause or worsen movement problems, including shaking (tremors). The medication can also cause you to have more stomach acid, putting you at risk for stomach ulcers and stomach bleeding. In addition, it can slow down your heart rate, which can put you at risk of fainting or falling. Rivastigmine patch (Exelon) can also worsen breathing problems in people with asthma or chronic obstructive pulmonary disease (COPD).
Make sure your care team knows about all of your medical conditions and medications you take. This will help your prescriber decide what rivastigmine patch (Exelon) dose is safe for you and how often you should follow up with them.
Rivastigmine patch (Exelon) dosage
The average cost for 1 carton of 30 patches of 4.6mg/24 hours of Rivastigmine patch (Exelon) is $51.59 with a free GoodRx coupon. This is 88.66% off the average retail price of $454.99. 
Carton
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 30 patches of 4.6mg/24 hours | 1 carton | $51.59 | $51.59 |
| 30 patches of 9.5mg/24 hours | 1 carton | $51.92 | $51.92 |
| 30 patches of 13.3mg/24 hours | 1 carton | $52.32 | $52.32 |
Typical dosage for Rivastigmine patch (Exelon)
The rivastigmine patch (Exelon) is available in three strengths: 4.6 mg, 9.5 mg, and 13.3 mg. Each patch releases medication over 24 hours.
The typical starting dose is one 4.6 mg patch applied onto the skin every 24 hours. The maximum dose is one 13.3 mg patch applied every 24 hours.
Your prescriber might adjust the dose depending on how well the medication is helping you and whether you're having bothersome side effects.
Interactions between Rivastigmine patch (Exelon) and other drugs
Rivastigmine patch (Exelon) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Rivastigmine patch (Exelon). Please note that only the generic name of each medication is listed below.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bromopride
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Amifampridine
- Atenolol
- Betaxolol
- Bisoprolol
- Bupropion
- Carteolol
- Carvedilol
- Celiprolol
- Donepezil
- Esmolol
- Labetalol
- Levobunolol
- Metipranolol
- Metoclopramide
- Metoprolol
- Nadolol
- Nebivolol
- Oxprenolol
- Penbutolol
- Pindolol
- Practolol
- Propranolol
- Sotalol
- Timolol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Rivastigmine patch (Exelon) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Rivastigmine patch (Exelon) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Rivastigmine patch (Exelon) will not be safe for you to take.
- Previous allergic skin reaction to the rivastigmine patch (Exelon)
What are alternatives to Rivastigmine patch (Exelon)?
There are a number of medications that your doctor can prescribe in place of Rivastigmine patch (Exelon). Compare a few possible alternatives below.
News about Rivastigmine patch (Exelon)
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Donepezil and rivastigmine patches are in the same class of medications and have similar uses. However, there are a few differences to keep in mind.
Rivastigmine patch (Exelon) images
