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What should I discuss with my healthcare provider before using rivastigmine transdermal (Exelon)?

You should not use rivastigmine if you are allergic to it.

To make sure you can safely use rivastigmine transdermal, tell your doctor if you have any of these other conditions:

• liver disease;
• recent weight loss or lack of appetite;
• a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats);
• a history of stomach ulcer;
• an enlarged prostate or urination problems;
• epilepsy or other seizure disorder;
• asthma or any allergies; or
• tremors (dyskinesia) or uncontrolled muscle movements.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether rivastigmine transdermal passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use rivastigmine transdermal (Exelon)?

Use exactly as prescribed by your doctor. Do not apply more patches or use them for longer than recommended. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Never cut or tear a rivastigmine patch.

Apply the skin patch to a flat, hairless area of the chest, back, side, or outer side of your upper arm. Press the patch firmly with the palm making sure it sticks firmly, especially around the edges.

Avoid placing the patch where it will be rubbed by tight clothing, or in the folds of your skin. The patch should remain flat on the skin at all times. Take care to avoid accidentally removing the patch while showering or during physical activity.

You will wear the patch for 24 hours and then remove it and put on a new one. Apply the new patch to a different skin area on your back each day. Do not use the same spot again for at least 14 days.

Always remove an old patch before putting on a new one. Do not wear more than 1 patch at a time.

If a patch falls off, apply a new patch and wear it for the rest of the day. Change the patch at your usual time the next day.

After removing a skin patch fold it in half, sticky side in, and throw it away where children and pets cannot get to it.

Always wash your hands after removing the patch.

If you need surgery, tell the surgeon ahead of time that you are using rivastigmine transdermal. You may need to stop using the medicine for a short time.

It may take up to 4 weeks of using this medicine before your symptoms improve. For best results, keep using the patches as directed.

If you stop using rivastigmine transdermal for any reason, do not restart the medication without talking to your doctor first. You may need to restart treatment with a lower dose.

Store at room temperature away from moisture and heat. Keep each patch in its foil pouch until you are ready to use it.

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