Advertisement

Generic Name:

rivastigmine, Transdermal patch

All Brands

  • Exelon Patch
SECTION 1 of 5

Highlights for rivastigmine

Transdermal patch
1

Rivastigmine is used to treat dementia caused by Alzheimer’s disease and Parkinson’s disease. 

2

Your dose depends on the condition that you’re treating, form of the drug that you’re taking, and other health problems you have. Your doctor will decide a dose that’s right for you.

3

This drug may cause a serious skin reaction. Symptoms of this skin reaction include: itching, redness, swelling, warmth, tenderness, peeling, or blistering of your skin. You may need to stop taking rivastigmine if this happens.

4

Rivastigmine may increase the acid in your stomach. This can cause severe stomach problems, including bleeding in your stomach (ulcers).

5

Common side effects include stomach problems, depression, anxiety, trouble sleeping, muscle weakness, headache, dizziness, and urinary tract infections.

IMPORTANT INFORMATION

Stomach problems

This drug may increase the acid in your stomach. This can cause severe stomach problems, including bleeding in your stomach (ulcers). If this happens, your doctor may tell you to stop taking this drug.

Overdose

You shouldn’t wear more than one patch at the same time. If you do, you may need to be hospitalized. This may even be fatal. It’s important to remove the old patch before you put on the new patch.

Skin reactions

The topical patch may cause a serious skin reaction called allergic contact dermatitis. Skin symptoms include: itching, redness, swelling, warmth, tenderness, peeling and blistering. You should remove the patch and call your doctor if the reactions spread past the patch size, are severe, and don’t get better within 48 hours of taking off the patch.

What is rivastigmine?

This drug is a prescription drug. It’s available in these forms: oral capsule, oral solution, and topical patch.

This drug is available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug may be used as part of a combination therapy. That means you need to take it with other drugs.

Why it's used

This drug is used to treat:

  • mild, moderate, and severe dementia caused by Alzheimer’s disease
  • mild to moderate memory dementia caused by Parkinson’s disease

More Details

How it works

This drug belongs to a class of drugs called cholinesterase inhibitors. A class of drugs refers to medications that work similarly. They have similar chemical structure and are often used to treat similar conditions.

This drug increases the amount of certain substances in your brain that may improve your memory and thinking.

Why it's used

This drug is used to treat:

  • mild, moderate, and severe dementia caused by Alzheimer’s disease
  • mild to moderate memory dementia caused by Parkinson’s disease

When you have dementia, your mental function may be getting worse. You may have memory loss, confusion, and other thinking or behavior problems. These issues may affect your ability to do daily tasks.

This drug doesn’t cure Alzheimer’s disease. All people with this condition get worse over time.

Advertisement
SECTION 2 of 5

rivastigmine Side Effects

Transdermal patch

Most Common Side Effects

The most common side effects that occur with rivastigmine include:

  • stomach problems, such as:

    • stomach pain
    • nausea
    • diarrhea
    • vomiting
    • heartburn
  • anxiety

  • depression

  • trouble sleeping

  • headache

  • dizziness

  • tiredness

  • urinary tract infections

  • muscle weakness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • stomach problems. Symptoms include:

    • bleeding in your stomach (ulcers)
  • skin problems. Symptoms include:

    • itching
    • redness
    • swelling
    • warmth
    • tenderness of the skin
    • peeling or blistering of the skin that may ooze, drain, or crust over
  • heart problems. Symptoms include:

    • slow heart rate (bradycardia)
    • fainting
  • seizures

  • problems with movement (tremors)

Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Don’t touch your eyes after you touch the topical patch. If you accidentally touch your eyes or if your eyes become red after handling the patch, rinse immediately with plenty of water and call your doctor if your symptoms don’t go away.

This drug can cause drowsiness, dizziness, weakness, or fainting. Do not drive, operate heavy machinery, or do other dangerous activities until you know how this drug affects you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

rivastigmine May Interact with Other Medications

Transdermal patch

Rivastigmine can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Medications that might interact with this drug

Anesthesia medications

Using rivastigmine with certain anesthesia medications may make your muscles relax too much during surgery.

Dementia medications

These drugs work similarly to rivastigmine. Your risk of side effects may be higher if you take these drugs together.

These drugs include:

  • tacrine
  • galantamine
  • donepezil

High blood pressure drugs

These drugs may slow down your heart rate too much when used with rivastigmine.

These drugs include:

  • atenolol
  • metoprolol
  • propranolol
  • acebutolol

Overactive bladder drugs

These drugs may not work as well when taken with rivastigmine.

These drugs include:

  • oxybutynin
  • tolterodine

Stomach problems drugs

These medicines increase your risk of tremors when used with rivastigmine.

These drugs include:

  • metoclopramide

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
neurological problems
People with neurological problems

This drug may increase your risk of tremors or seizures.

heart problems
People with heart problems

This drug may cause your heart rate to slow down too much.

urination problems
People with urination problems

If you have problems urinating, this drug many make your condition worse. This drug may make it harder for your bladder muscles to contract.

breathing problems
People with breathing problems

Use this drug with caution if you have a history of asthma or obstructive pulmonary disease.

ulcers
People with ulcers

This drug can increase your stomach acid. This raises your risk of stomach bleeding or ulcers. Tell your doctor if you have a history of ulcers or take drugs like aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). You may have a higher risk for ulcers.

pregnant women
Pregnant women

This drug is a pregnancy category B drug. That means two things:

  1. Research in animals hasn’t shown a risk to the fetus when the mother takes the drug.
  2. There aren’t enough studies done in humans to show if the drug poses a risk to the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. Animal studies don’t always predict the way humans would respond. Therefore, this drug should only be used in pregnancy if clearly needed.

breast-feeding
Women who are breast-feeding

It isn’t known if this drug passes into breast milk. If it does, it may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

children
For children

The safety and effectiveness of this drug in people under 18 years of age haven’t been established.

contact with drug
Contact with drug

When you take off an old patch, fold it in half with the sticky sides together.  This helps make sure that no one else is exposed to the drug in the patch.

allergies
Allergies

This drug may cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives
  • severe skin reactions

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 5

How to Take rivastigmine (Dosage)

Transdermal patch

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Alzheimer’s disease

Brand: Exelon

Form: Topical patch
Strengths: 4.6 mg/24 hours, 9.5 mg/24 hours, 13.3 mg/24 hours

Generic: rivastigmine

Form: Topical patch
Strengths: 4.6 mg/24 hours, 9.5 mg/24 hours, 13.3 mg/24 hours
Adult dosage (ages 18 years and older)
  • starting dose: one 4.6 mg per 24-hour patch applied to your skin once per day
  • dose changes:
    • After 4 weeks, your doctor may increase your dose to the 9.5 mg per 24-hour patch applied once per day. After another 4 weeks, your doctor may switch you to the 13.3 mg per 24-hour patch applied once per day.
  • maintenance dose:
    • mild to moderate Alzheimer’s disease:
      • 9.5 mg per 24-hour patch or 13.3 mg per 24-hour patch applied once per day
    • severe Alzheimer’s disease:
      • 13.3 mg per 24-hour patch applied once per day
  • interruption of treatment:
    • If you don’t apply your patch for up to 3 days, restart treatment with the same or lower strength of the patch.
    • If it’s been more than 3 days since you applied the patch, start treatment again with the 4.6 mg per 24-hour patch once per day.
Child dosage (ages 0–17 years)

The safety and effectiveness of rivastigmine in people under 18 years of age haven’t been established.

Special considerations

Liver problems: If you have mild to moderate liver disease, you should use the 4.6 mg per 24-hour patch applied once per day. This will be both your starting and maintenance dose.

Low body weight: Your doctor should carefully increase your dose if you weigh less than 110 lbs. (50 kg). People with low body weight may have a higher risk of side effects, such as nausea and vomiting. Your doctor may lower your maintenance dose to the 4.6 mg per 24-hour patch applied once per day if you have side effects.

Warnings

You should only wear one patch at a time. Always remove the old patch before applying the new patch.

Parkinson’s disease dementia

Brand: Exelon

Form: Topical patch
Strengths: 4.6 mg/24 hours, 9.5 mg/24 hours, 13.3 mg/24 hours

Generic: rivastigmine

Form: Topical patch
Strengths: 4.6 mg/24 hours, 9.5 mg/24 hours, 13.3 mg/24 hours
Adult dosage (ages 18 years and older)
  • starting dose: one 4.6 mg per 24-hour patch applied to the skin once per day
  • dose changes:
    • After 4 weeks, your doctor may increase your dose to the 9.5 mg per 24-hour patch applied once per day. After another 4 weeks, your doctor may switch you to the 13.3 mg per 24-hour patch applied once per day.
  • maintenance dose: 9.5 mg per 24-hour patch or 13.3 mg per 24-hour patch applied once per day.
  • interruption of treatment:
    • If you don’t apply your patch for up to 3 days, restart treatment with the same or lower strength of the patch.
    • If it’s been more than 3 days since you applied the patch, start treatment again with the 4.6 mg per 24-hour patch once per day.
Child dosage (ages 0–17 years)

The safety and effectiveness of rivastigmine in people under 18 years of age haven’t been established.

Special considerations

Liver problems: If you have mild to moderate liver disease, you should use the 4.6 mg per 24-hour patch applied once per day. This will be both your starting and maintenance dose.

Low body weight: Your doctor should carefully increase your dose if you weigh less than 110 lbs. (50 kg). People with low body weight may have a higher risk of side effects, such as nausea and vomiting. Your doctor may lower your maintenance dose to the 4.6 mg per 24-hour patch applied once per day if you have side effects.

Warnings

You should only wear one patch at a time. Always remove the old patch before applying the new patch.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Rivastigmine comes with serious risks if you don’t take it as prescribed.

If you don't take it at all

If you don’t take it at all, your memory problems, confusion, and other thinking or behavior problems may get worse.

If you skip or miss doses

If you skip or miss doses, this medicine may not work as well.

If you take too much

If you take too much of this medication, you may have more side effects. These include:

  • severe nausea and vomiting
  • changes in your blood pressure
  • sweating
  • drooling
  • trouble breathing
  • seizures
  • hallucinations
  • tremors

If you think you’ve taken too much of the drug, act right away. Call your doctor or local Poison Control Center, or go to the nearest emergency room.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time.

Never try to catch up by taking two doses at once. This could cause toxic side effects.

How to tell if the drug is working

If this drug is working your memory may get better and you may have an easier time doing daily tasks.

Rivastigmine is used for long-term treatment.

Only one patch should be applied every 24 hours

Change the patch at the same time of day. You may want to write the date and time you put on the patch with a ballpoint pen before applying the patch to help you remember when to remove it.

Store this drug carefully

  • Store this drug at room temperature between 59°F and 86°F (15°C and 30°C).
  • Keep this drug away from light and high temperatures.
  • Keep the patch in its individual sealed pouch until you’re ready to use it. 
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

You should only wear one patch at a time.

Don’t open the pouch or remove the patch until you’re ready to apply it.

  • Using the patch:
    • Step 1:
      • Choose an area to apply the patch. The patch should be applied to healthy skin that’s clean, dry, hairless, and doesn’t have redness, irritation, burns, or cuts.
      • The patch can be applied to your upper or lower back, left or right upper arm, or left or right side of the chest. Once you choose a spot, don’t apply another patch to that area again for at least 14 days.
    • Step 2:
      • Remove the patch from the pouch by carefully cutting the pouch along the dotted line. Save the pouch for later.
    • Step 3:
      • A protective liner covers the sticky side of the patch. Peel off one side of the protective cover. Don’t touch the sticky part of the patch with your fingers.
    • Step 4:
      • Apply the sticky side of the patch to your skin. Then peel off the other side of the protective cover.
      • Press down on the patch firmly for 30 seconds to make sure the edges stick to your skin.
    • Step 5:
      • Wash your hands with soap and water right away.
      • If your patch falls off, choose a new area on your skin and repeat steps 2–5 to apply a new patch.
      • Replace the new patch the next day at the same time as usual.
  • Removing your patch: Gently pull on 1 edge of the patch to remove it from your skin.
  • Throwing away the used patch:
    • Step 1:
      • Fold the used patch in half, with the sticky sides together, and put it back into the pouch that you saved.
      • Throw away the used patch safely and out of reach of children.
      • Don’t try to re-use the patch.
    • Step 2:
      • If any sticky substance remains on your skin after you take off the patch, use soap and water to remove it.  You can also use baby oil. Don’t use alcohol or other dissolving liquids.

Clinical monitoring

Before starting and during treatment with this drug, your doctor may monitor the following:

  • upper endoscopy. This test looks at the lining of your upper digestive tract. You may have this test if your doctor thinks you have an ulcer.
  • changes in weight. Your doctor should check your weight. Changes in weight can increase or decrease the level of the drug in your body.

Sun sensitivity

Avoid exposure to heat sources such as excessive sunlight, saunas, or sun-rooms for long periods of time.

Hidden costs

You may need to pay for an upper endoscopy and/or allergy testing if you have side effects from this drug.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

SECTION 5 of 5

How Much Does rivastigmine Cost?

Transdermal patch

We've partnered with GoodRx so you can compare prices, find discounts and save up to 80% on your next prescription. Check out the low coupon prices below — no insurance required.

Compare prices and save up to 80% on your next refill!

Lowest price for rivastigmine

Walmart $57.92
Membership warehouse $75.04
Safeway $75.09
These prices represent the lowest priced national pharmacies for rivastigmine on GoodRx. They may be lower than your insurance.

Enter your zip code to find the best deal near you.

These prices represent the lowest priced national pharmacies for rivastigmine on GoodRx. They may be lower than your insurance.

Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on September 3, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Advertisement
Advertisement
Advertisement