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EXELON
Alzheimer's dementia
Parkinsonism
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Drug Name:

EXELON Rx

Generic Name and Formulations:
Rivastigmine (as tartrate) 1.5mg, 3mg, 4.5mg, 6mg; caps.

Company:
Novartis Pharmaceuticals Corp

Therapeutic Use:

Indications for EXELON:

Mild to moderate dementia of the Alzheimer's type.

Adult:

Take with food in the AM and PM. Soln: may give directly from syringe or mix with water, fruit juice, or soda. Caps and soln may be interchanged at equal doses. Initially 1.5mg twice daily; if well-tolerated, may increase by 1.5mg twice daily at intervals of at least 2 weeks. Usual range: 6–12mg/day; max 12mg/day. If dose is not tolerated, suspend for several doses and restart at same or next lower dose. If stopped for >3 days, restart at 1.5mg twice daily and retitrate. Renal or mild-to-moderate hepatic impairment: use lower doses. Low body wt. (<50kg): monitor for toxicities and consider reducing dose.

Children:

<18yrs: not recommended.

Contraindications:

Patches: previous history of application site reactions suggestive of allergic contact dermatitis (in the absence of negative allergy testing).

Warnings/Precautions:

Monitor for nausea, vomiting, anorexia, weight loss, GI bleed. Sick sinus syndrome, other supraventricular conduction disturbances. Seizures. History or risk of ulcers. Urinary obstruction. Asthma. COPD. Discontinue if disseminated allergic dermatitis occurs. Renal or hepatic impairment. Pregnancy (Cat.B). Nursing mothers: not recommended.

Interactions:

Antagonizes anticholinergics. May potentiate succinylcholine-type muscle relaxants, other cholinesterase inhibitors, cholinergic agonists. Monitor for GI bleed with NSAIDs. Concomitant metoclopramide, beta-blockers: not recommended.

See Also:

EXELON ORAL SOLUTION

EXELON PATCH

Pharmacological Class:

Reversible acetylcholinesterase inhibitor (carbamate deriv).

Adverse Reactions:

Nausea, vomiting, anorexia, dyspepsia, asthenia, diarrhea, abdominal pain, dizziness, weight loss, tremor, malaise, hyperhidrosis, cholinergic effects; also, patches: application site reactions, allergic contact dermatitis (discontinue if suspected or no improvements within 48hrs after removal; or consider switching to oral form only after negative allergy testing; monitor).

Generic Availability:

Caps, patches (YES); soln (NO)

How Supplied:

Caps—60, 500; Soln—120mL (w. dosing syringe); Patches—30

Indications for EXELON:

Mild to moderate dementia associated with Parkinson's disease.

Adult:

Take with food in the AM and PM. May mix soln with water, fruit juice, or soda. Caps and soln may be interchanged at equal doses. Initially 1.5mg twice daily; if tolerated, may increase by 1.5mg twice daily at intervals of at least 4 weeks. Usual range: 3–12mg/day; max 12mg/day. If dose is not tolerated, suspend for several doses and restart at same or next lower dose. If stopped for >3 days restart at 1.5mg twice daily and retitrate. Renal or mild-to-moderate hepatic impairment: use lower doses. Low body wt. (<50kg): monitor for toxicities and consider reducing dose. Patch: Apply to clean, dry, hairless intact skin. Rotate application site (allow 14 days before reapplying to same site). Initially apply one 4.6mg/24hrs patch once daily; if tolerated, may increase to 9.5mg/24hrs patch after 4 weeks at previous dose; can further be increased to max 13.3mg/24hrs dose. If dosing interrupted for >3 days, restart with 4.6mg/24hrs patch and titrate again. Mild-to-moderate hepatic impairment: initial and max dose 4.6mg/24hrs patch. Low body wt. (<50kg): monitor for toxicities and consider reducing maintenance dose to 4.6mg/24hr patch. Switching from capsules or oral solution: see full labeling.

Children:

<18yrs: not recommended.

Contraindications:

Patches: previous history of application site reactions suggestive of allergic contact dermatitis (in the absence of negative allergy testing).

Warnings/Precautions:

Monitor for nausea, vomiting, anorexia, weight loss, GI bleed. Sick sinus syndrome, other supraventricular conduction disturbances. Seizures. History or risk of ulcers. Urinary obstruction. Asthma. COPD. Discontinue if disseminated allergic dermatitis occurs. Renal or hepatic impairment. Pregnancy (Cat.B). Nursing mothers: not recommended.

Interactions:

Antagonizes anticholinergics. May potentiate succinylcholine-type muscle relaxants, other cholinesterase inhibitors, cholinergic agonists. Monitor for GI bleed with NSAIDs. Concomitant metoclopramide, beta-blockers: not recommended.

See Also:

EXELON ORAL SOLUTION

EXELON PATCH

Pharmacological Class:

Reversible acetylcholinesterase inhibitor (carbamate deriv).

Adverse Reactions:

Nausea, vomiting, anorexia, dyspepsia, asthenia, diarrhea, abdominal pain, dizziness, weight loss, tremor, malaise, hyperhidrosis, cholinergic effects; also, patches: application site reactions, allergic contact dermatitis (discontinue if suspected or no improvements within 48hrs after removal; or consider switching to oral form only after negative allergy testing; monitor).

Generic Availability:

Caps, patches (YES); soln (NO)

How Supplied:

Caps—60, 500; Soln—120mL (w. dosing syringe); Patches—30

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