It's important to know exactly how to use the Exelon Patch (rivastigmine transdermal system), where to apply it, and what kinds of activities your loved one can keep doing while wearing it. That's why we've put together this list of frequently asked questions.
Does the Exelon Patch come in different doses?
Yes. Exelon Patch is available in three dosage strengths. Doctors typically prescribe a starting dose of 4.6 mg/24 hours per patch to assess tolerability. If the starting dose is well-tolerated after 4 weeks, ask the doctor if introducing the recommended effective dose of 9.5 mg/24 hours is right for your loved one. When greater benefit is needed while on the 9.5 mg/24 hours patch and if still well tolerated for 4 weeks, your loved one's doctor may prescribe the maximum effective dose of 13.3 mg/24 hours.
When should I ask about higher dose?
After 4 weeks, if your loved one is tolerating the medication, ask the doctor if introducing the recommended effective dose of 9.5 mg/24 hours is right for him or her. Only after treatment has been titrated to a dose of 9.5 mg/24 hours and if greater benefit is needed, will treatment with a dose of 13.3 mg/24 hours be considered.
For special populations (patients under 50 kg [110 lb] and patients with moderate to severe renal impairment and/or mild to moderate hepatic impairment), the HCP will consider using Exelon Patch 4.6 mg/24 hours as the initial and maximum dose.
How should I store the Exelon Patch?
You should store the Exelon Patch in its unopened, protective pouch at room temperature, between 59° and 86° F, and out of direct sunlight. Be sure to keep the Exelon Patch and all medicines in a safe, secure place out of the reach of children. Throw away any unused medicine after the expiration date.
Can I open the Exelon Patch pouches in advance?
No. Once the pouch is opened, the Exelon Patch should be immediately applied. Patches start to lose medicine and become less effective if left opened.
Can I cut the Exelon Patch?
No. The Exelon Patch should not be cut or folded sharply.
Can I write the date on the Exelon Patch?
You may write on the Exelon Patch with a thin ballpoint pen.
Is the Exelon Patch still effective if it isn't used for a few months?
Unopened patches can be used up to the expiration date printed on the protective pouch. Once the pouch is opened, the Exelon Patch should be applied immediately. Patches start to lose their medicine when exposed to the air.
Can heat affect how the Exelon Patch works?
Exelon Patch should be kept out of excessive sunlight or saunas for long periods of time.
Is the Exelon Patch effective for underweight people?
Speak with your doctor if your loved one weighs less than 50 kg/110 pounds, as patients with a body weight below 50 kg/110 pounds may experience more adverse events. Caution should be used in higher than recommended doses.
For this population, the HCP will consider using Exelon Patch 4.6 mg/24 hours as the initial and maximum dose.
Is the Exelon Patch effective for overweight people?
Speak with your doctor if your loved one is overweight. No specific studies investigating overweight people have been conducted.
What should I do if I or my loved one touches the sticky part of the Exelon Patch?
The medicine goes through the adhesive part of the Exelon Patch; therefore, the person who touched the sticky part of the patch should clean his or her hands with soap and water as soon as possible. Avoid contact with the eyes.
What should I do if my loved one places the Exelon Patch in his or her mouth?
Remove the Exelon Patch from your loved one's mouth and contact the doctor immediately. Your loved one may have ingested some of the medicine in the patch; how much depends on how long it was chewed. Make sure that no part of the patch is still in his or her mouth.
What should I do if a child applies or swallows the Exelon Patch?
If a child comes into contact with the Exelon Patch out of its protective pouch, take the patch away and immediately contact a doctor. If a doctor cannot be reached, call the local poison control center, or the emergency department at a local hospital. Used and unused patches should be kept out of the reach of children and disposed of in a place away from children.
How do I remove any adhesive that's left over from the Exelon Patch?
Gently soak the area with warm water and mild soap, or use a small amount of baby oil to remove any residue. If the rings of adhesive become soiled, you may need to use a medical adhesive removal pad that should be available from a pharmacist. Alcohol or other dissolving liquids (nail polish remover or other solvents) may irritate the skin and should not be used.
How can I remove an Exelon Patch that isn't coming off?
Use your fingers to work an oil-based product such as baby oil into the patch. This should help to break the adhesive up so that you can remove the patch more easily. You must remove the previous day's Exelon Patch before applying a new one.
Is the Exelon Patch safe for people to wear while undergoing an MRI?
Speak with the doctor if your loved one needs to have an MRI. The Exelon Patch has not been studied in use by people while having an MRI. Please contact your doctor for further information.
Does rubbing the Exelon Patch affect how much medicine is released?
Rubbing the Exelon Patch has not been studied.
Is the Exelon Patch available in different colors?
No, it is only available in beige.
Why is the brand name printed on the Exelon Patch?
The name is there for the safety of the patient as well as for those who may come in contact with a discarded patch. Because patches are popular for different treatments, having the name there also makes it easier to tell the Exelon Patch apart from other patches.
Application
What should I do if I forgot to apply the Exelon Patch?
If you have not been applying the Exelon Patch for three days, do not apply the next patch before you have talked to a doctor. If you forgot to apply your loved one's Exelon Patch, remove the old patch and apply a new one immediately. Apply the next patch at the usual time the next day.
What should I do if the Exelon Patch keeps falling off?
If the Exelon Patch is not staying on during application, it is possible that the skin is wet or that it is not pressed firmly into place. Also, some soaps, creams, or lotions may keep the patch from sticking. Check with your doctor or pharmacist to make sure you followed the application instructions correctly.
If your Exelon Patch falls off, put on another patch right away and then replace the new patch the next day at the same time as usual. Do not use overlays, bandages, or tape to secure patches that have loosened or reapply patches that have fallen off.
Can I open the Exelon Patch pouches at the beginning of the week for easier access?
No. You should only open the pouch when you are ready to apply the patch. The Exelon Patch starts to lose medicine and become less effective if exposed to air and left open.
How close can the Exelon Patch be to medicated patches treating other conditions?
This has not been studied; however, we do not recommend overlapping a patch treating something different.
Tell the doctor about all other prescription or nonprescription medicines the patient is taking. Exelon products should not be taken at the same time with other medicines that have a similar effect on the body and the brain (cholinomimetic agents) or with anticholinergic medicines. Inform the doctor if the patient needs surgery requiring anesthesia while using the Exelon Patch.
Is it OK to shave the application site before I apply the Exelon Patch?
You can shave the application site. However, it's best not to shave the site just prior to application because the skin is often slightly irritated from shaving. If you must shave a site, do so 24 hours before applying the patch.
Can lotions (moisturizing lotions, tanning lotions, etc.) affect the Exelon Patch?
Always apply your loved one's patch to clean, dry skin. Do not use creams, oils, powder, or makeup on skin where you are going to put the patch or near a patch he or she is wearing.
How should the Exelon Patch be applied to a person with a preexisting skin problem?
Speak to your doctor regarding preexisting skin problems. The Exelon Patch has not been studied in patients with preexisting skin problems.
How should the Exelon Patch be applied to a person with oily skin?
If your loved one has oily skin, it may be more difficult to keep the patch on. Gently clean the application area with soap and warm water and pat the area dry with a towel. Then immediately apply the patch, pressing firmly.
What should I do if the person being treated is sunburned?
Do not apply the Exelon Patch to oily, broken, burned, sunburned, cut, or irritated skin. Choose another area to apply the patch, as shown in the instructions.
Can the Exelon Patch be applied over a tattoo?
It is not recommended that the patch be applied over a tattoo.
What should I do if my loved one experiences a skin reaction?
If this happens to your loved one, remove the patch and rinse the area with cool water. If the reaction is severe, stop using the Exelon Patch and talk with your doctor. People with an allergy to adhesives should not use the Exelon Patch. To help minimize skin irritation, apply the patch to a different spot of skin every day. Do not apply the patch to the same exact spot for at least 14 days.
Patient Activity
Can the Exelon Patch be worn when bathing, swimming, or in the sun?
Bathing, swimming, or showering should not affect the patch. You can wear the patch under your swimsuit. Make sure the patch does not loosen during these activities.
The patch should not be exposed to any external heat sources (e.g., excessive sunlight, saunas, solarium) for long periods of time.
EXELON PATCH can cause gastrointestinal adverse reactions, including significant nausea, vomiting, diarrhea, decreased appetite, and weight loss. Dehydration may result from prolonged vomiting or diarrhea and can be associated with serious outcomes. The incidence and severity of these reactions are dose related. For this reason, treatment should be initiated with EXELON PATCH at a dose of 4.6 mg/24 hours and titrated to a dose of 9.5 mg/24 hours, if appropriate. If you have not taken EXELON PATCH for more than 3 days, do not start taking it again until you have talked to a doctor.
