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Rivastigmine transdermal patch was developed by the Swiss company Novartis and was initially approved by the US FDA in 2000, becoming the world's first transdermal patch for the treatment of Alzheimer's disease.
1. Common name: Rivastigmine (Rivastigmine)
2. Trade name: Exelon®Patch (Exelon® Patch)
1. Treatment of mild to moderate Alzheimer’s type dementia
2. Treatment of mild to moderate dementia related to Parkinson’s disease
1. 4.6mg/24 Hourly specification: 5cm² patch, containing 9mg rivastigmine
2. Properties: opaque plastic patch, four-layer structure (backing layer, drug matrix layer, adhesive layer, release liner)
1. Active Ingredients: Rivastigmine ((S)-3-[1-(Dimethylamino)ethyl]phenylethylmethylcarbamate)
2. Excipients: acrylic copolymer, silicone adhesive, silicone oil, vitamin E, etc.
1. Initial dose: 4.6mg/24-hour patch, once a day
2. Maintenance dose: If tolerated well after 4 weeks, increase to 9.5mg/24-hour patch (recommended effective dose)
3. Maximum dose: 9.5mg/24 Hours, higher doses have no additional benefit and increase adverse reactions
4. How to use: Apply to clean and dry back, upper arm or chest skin, change the site daily
1. Underweight patients (<50 kg): The dose needs to be adjusted carefully, and it may be necessary to maintain 4.6mg/24 hours
2. Treatment interruption> for several days: need to restart from the lowest dose
3. Oral preparation conversion:
Original daily dose <6mg oral: directly switch to 4.6 mg/24-hour patch
Original daily dose of 6-12 mg orally: directly switch to 9.5 mg/24-hour patch
1. Medication time: no need to consider before and after meals
2. Treatment of missed doses: Apply a new patch immediately, and replace it according to the original plan the next day
3. Treatment of vomiting: Pause treatment for a few days and then restart from a low dose
4. Skin care: Avoid areas where cream/talcum powder has been used recently, and do not repeat the same area within 14 days Use
5. Special tips:
Fold and discard after use to prevent children from coming into contact with residual drugs
Bathing/swimming will not affect the patch, but long-term exposure to high temperatures needs to be avoided
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1. Pregnant women: use only when the benefits outweigh the risks (pregnancy level B)
2. Lactation: contraindicated (the drug may be excreted in breast milk)
3. Children: no safety and efficacy data
4. Liver dysfunction: no adjustment required Dosage, but individualized titration is required
5. Renal insufficiency: no dose adjustment required
6. Elderly patients: age does not affect pharmacokinetics
1. Common (≥5%): nausea ( 7%), vomiting (6%), diarrhea (6%)
2. Skin reaction: erythema/itching at the application site (mostly mild)
3. Other important adverse reactions:
Weight loss (≥7% baseline weight: 8%)
Head Dizziness, headache, loss of appetite
4. Rare but serious: gastrointestinal bleeding, epileptic seizures, extrapyramidal symptoms
Known allergy to rivastigmine, other carbamate derivatives or ingredients of the patch
Lactating women
1. Prohibited combination with: other cholinergic drugs (including oral rivastigmine preparations)
2. Use with caution in combination with:
Succinylcholine muscle relaxants ( May enhance effects during anesthesia)
Anticholinergics (may antagonize each other)
1. Store at room temperature (15-30°C)
2. Keep sealed until use
3. Discarded patches must be folded and discarded safely