Initially 4.6 mg/day. May be increased up to 9.5 mg/day if well tolerated after a min of 4 wk. After a min of 6 mth, the physician may increase the dose to 13.3 mg/24 hr. Apply patch once daily to clean, dry, hairless, intact, healthy skin preferably on the upper or lower back, upper arm or chest.
Hypersensitivity to rivastigmine or other carbamate derivatives. Previous history of application site reactions suggestive of allergic contact dermatitis w/ rivastigmine patch.
If treatment is interrupted for >3 days, it should be re-initiated w/ 4.6 mg/24 hr. GI disorders may occur at initiation of therapy & shortly after dose increase. Monitor patient's wt during therapy. Sick sinus syndrome, conduction defects (SA & AV block), active gastric or duodenal ulcers or patient predisposed to these conditions; predisposed to urinary obstruction & seizures; history of asthma or obstructive pulmonary disease. Discontinue if allergic contact dermatitis occur. May exacerbate or induce extrapyramidal symptoms. Avoid contact w/ the eyes. Patient <50 kg body wt. Hepatic & renal impairment. May impair ability to drive or operate machinery. Pregnancy & lactation. Ped patient.
Extra-pyramidal effect w/ metoclopramide. Additive effect w/ anticholinergic drugs (eg, oxybutynin, tolterodine). Exaggerated effects of succinylcholine-type muscle relaxants during anaesth. Additive effect leading to bradycardia w/ β-blocker. Do not give concomitantly w/ other cholinomimetic substances. Inhibits the butyrylcholinesterase-mediated metabolism of other substances.
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