Before taking rivastigmine

Before taking rivastigmine make sure your doctor or pharmacist knows:

• If you have heart problems.
• If you have asthma or chronic obstructive pulmonary disease (COPD).
• If you have ever had problems with stomach or duodenal ulcers.
• If you have ever had seizures (fits).
• If you have liver or kidney problems.
• If you have problems passing urine.
• If you are pregnant, trying for a baby or breast-feeding.
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic reaction to this or to any other medicine.

How to take rivastigmine

• Before beginning treatment, read the manufacturer's printed information leaflet.
• Take rivastigmine exactly as directed by your doctor. If you have been given the capsules or oral solution, take your doses with a meal or soon afterwards.
• Try to take rivastigmine at the same times each day to avoid missing any doses. Ideally it should be taken with, or soon after, your breakfast and your evening meal.
• The capsules must be swallowed whole without chewing or crushing. Taking your doses with a small drink of water will help.
• If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a missed dose.
• If you miss taking rivastigmine for several days, talk to your doctor before starting to take it again as you may need to re-start your treatment on a lower dose.

1. Open the bottle and remove the oral dosing syringe from its case.
2. Insert the nozzle of the syringe into the stopper on the top of the opened bottle.
3. Pull up the plunger on the syringe to withdraw the amount of solution required (removing any large air bubbles by moving the plunger up and down a few times).
4. Drink the solution directly from the syringe or stir it into a small amount of water before drinking.

1. Open a packet and remove a patch.
2. Apply one patch to an area of clean, dry, non-hairy skin on the back, upper arm, or chest.
3. After 24 hours remove this patch and apply another patch to a different area of clean, dry, non-hairy skin on the back, upper arm, or chest. Avoid using the same area of skin for at least 14 days.
4. Repeat this process each day, removing one patch before applying the next.

Getting the most from your treatment

• When starting your treatment your doctor will give you a small dose and then gradually increase the dose. This allows your doctor to make sure that you have the dose that helps your condition and avoids any unwanted symptoms.
• Your doctor will want to check your progress every few weeks to make sure the dose is right for you and that you are getting benefit from this treatment. Try to keep these regular doctor's appointments.
• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment that you are taking rivastigmine.
• If you buy any medicines, always check with a pharmacist that they are safe to take with your other medicines.

Can rivastigmine cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store rivastigmine

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Exelon® 1.5 mg, 3 mg, 4.5 mg, 6 mg Hard Capsules, Novartis Pharmaceuticals UK Ltd. electronic Medicines Compendium. Dated April 2010, accessed June 2010.
• Manufacturer's PIL, Exelon® Oral Solution, Novartis Pharmaceuticals UK Ltd, electronic Medicines Compendium. Dated April 2010, accessed June 2010.
• Manufacturer's PIL, Exelon® 4.6 mg/24h and 9.5 mg/24h transdermal patch, Novartis Pharmaceuticals UK Ltd, electronic Medicines Compendium. Dated April 2010, accessed June 2010.
• British National Formulary; 59th Edition (March 2010) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)