Rivastigmine Tartrate, Oral

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KEY POINTS

• This medicine is taken by mouth to treat certain kinds of dementia. Take it exactly as directed.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: acetylcholinesterase inhibitor

Generic and brand names: rivastigmine tartrate, oral; Exelon

What is this medicine used for?

This medicine is taken by mouth to treat symptoms of Alzheimer's-type dementia. It may also be used to treat dementia related to Parkinson's disease.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Asthma or other breathing problems
• Kidney or liver disease
• Heart disease or an irregular heartbeat, or a heart attack
• Seizures
• Trouble urinating
• Ulcers
• Uncontrolled muscle movements

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Your provider may adjust the dosage to find the one that is best. Do not take more or less or take it longer than prescribed. Do not stop taking this medicine without your healthcare provider's approval. Changing your dosage may cause a serious decline in your ability to think and control your behavior.

Check with your healthcare provider before using this medicine in children under age 18.

Take this medicine with food. Do not chew, crush, or break the capsule.

If you stop taking this medicine for more than a few days, do not take the next dose until you talk with your healthcare provider. The dose may need to be adjusted.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider. You may need to start the medicine again at a lower dose.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: severe nausea, vomiting, diarrhea, drooling, sweating, blurred vision, lightheadedness, slow heartbeat, shallow breathing, muscle weakness, fainting, seizures, drowsiness, tremor, confusion, hallucinations.

What should I watch out for?

This medicine may cause urinary problems. If you have trouble urinating, contact your healthcare provider right away.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

Smoking tobacco may lower the blood levels of this medicine. If you smoke, your healthcare provider may need to change the dosage of your medicine.

People who have Alzheimer's disease should not be allowed to drive, operate machinery, or perform other hazardous tasks. This medicine may cause dizziness and confusion, which can add to the problems caused by the disease itself.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Severe nausea, vomiting, stomach pain, weight loss, wheezing, hallucinations (seeing or hearing things that are not there), thoughts of suicide, worsening of tremors, seizures, blood in urine, black or tarry bowel movements, trouble urinating.

Other: Dizziness, diarrhea, nausea, loss of appetite, headache, tiredness, weakness, confusion, anxiety, trouble sleeping, constipation, gas, skin irritation.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alcohol
• Anticholinergic medicines such as amantadine (Symmetrel), belladonna, benztropine (Cogentin), dicyclomine (Bentyl), glycopyrrolate (Cuvposa, Robinul), hyoscyamine (HyoMax, Levbid, Levsin), methscopolamine (Pamine), propantheline, rimantadine (Flumadine), and trihexyphenidyl
• Antihistamines such as chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), hydroxyzine (Vistaril), and meclizine (Dramamine)
• Beta blockers (taken by mouth) such as acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carteolol, carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), nebivolol (Bystolic), sotalol (Betapace, Sorine), and timolol
• Bladder control medicines such as darifenacin (Enablex), mirabegron (Myrbetriq), oxybutynin (Ditropan XL, Oxytrol), solifenacin (VESIcare), tolterodine (Detrol), and trospium
• Ceritinib (Zykadia)
• Medicines to treat breathing or lung problems such as ipratropium (Atrovent) and tiotropium (Spiriva)
• Metoclopramide (Metozolv, Reglan)
• Muscle relaxants such as cyclobenzaprine (Amrix) and orphenadrine (Norflex)
• Myasthenia gravis medicines such as neostigmine (Prostigmin) and pyridostigmine (Mestinon, Regonol)
• Nicotine (smoking) and nicotine replacement products such as Habitrol, NicoDerm, Nicorette, Nicotrol
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Other Alzheimer's disease medicines such as donepezil (Aricept) and galantamine (Razadyne)
• Propranolol (Hemangeol, Inderal, InnoPran)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store the bottle upright at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.