Exelon 4.5mg Capsules

Rivastigmine is used to treat mild to moderately severe dementia in Alzheimer's disease, and dementia linked to Parkinson's disease.

It belongs to a group of medicines called cholinesterase inhibitors. It raises the level of acetylcholine, a chemical that helps nerve cells in the brain communicate. It can help with memory and thinking but does not cure the disease.

Use it exactly as your doctor or pharmacist tells you. The dose is usually started low and increased slowly.

• Capsules or liquid: take twice a day with morning and evening meals.
• Patches: wear only one patch at a time. Remove the old patch before putting on a new one every 24 hours. Apply to clean, dry, hairless skin on the upper or lower back, upper arm or chest, and use a different spot each day (not the same spot within 14 days). Do not cut the patch.
• If you miss a capsule dose, skip it if the next dose is nearly due. If you forget a patch, put one on straight away and change it at the usual time next day. Never double up.
• If you miss doses for more than 3 days, talk to your doctor before restarting, as you may need a lower dose.

Common side effects include:

• feeling or being sick, loss of appetite, weight loss or diarrhoea
• dizziness, headache, tiredness or drowsiness
• shaking, agitation, restlessness or confusion
• increased sweating
• skin redness or itching where the patch was

Get medical help straight away if you have:

• a slow or uneven heartbeat, fainting or chest pain
• black or bloody stools, or vomit that is bloody or looks like coffee grounds
• severe upper stomach pain with sickness
• fits (seizures), hallucinations or worsening Parkinson's symptoms
• yellow skin or eyes
• a skin reaction spreading beyond the patch, blisters or swelling

Check with your doctor or pharmacist before using it if you:

• have a heart condition such as a slow or irregular heartbeat
• have had a stomach ulcer or bleeding
• have difficulty passing urine, seizures, asthma or other breathing problems
• have liver or kidney problems, or a low body weight
• take metoclopramide, beta-blockers, anticholinergic medicines, or medicines that affect heart rhythm
• are due to have surgery (it can affect some anaesthetic muscle relaxants)

Store at room temperature away from heat and moisture, out of the reach of children. Keep patches in their sachets until use; fold used patches sticky sides together and throw away safely.

Patch overdose: wearing more than one patch can cause a dangerous overdose. If this happens, remove all patches and contact your doctor.

Heat: do not expose the patch to saunas, sunbeds or strong sun for long periods.

Driving: it can cause dizziness, fainting or confusion. Your doctor will advise whether you can drive.

Pregnancy and breastfeeding: use in pregnancy only if clearly needed, and do not breastfeed while using it.