Exelon

Exelon is a prescription medication used to treat dementia in people with Alzheimer's disease or Parkinson's disease. Exelon belongs to a group of drugs called acetylcholinesterase inhibitors. It works by increasing the amount of certain natural substances to improve mental function. 

Exelon is a prescription medicine used to treat dementia in people with Alzheimer's disease or Parkinson's disease.

• Novartis Pharmaceuticals Corporation

Exelon may cause serious side effects. See "Drug Precautions" section.

• nausea
• vomiting
• loss of appetite
• acid indigestion
• feeling weak or lack of energy

The most common side effects of Exelon patch include:

• depression
• headache
• anxiety
• dizziness
• stomach pain
• urinary tract infections
• muscle weakness
• tiredness
• trouble sleeping

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.  

These are not all the possible side effects of Exelon. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following:

• antihistamines (allergy medications)
• aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
• bethanechol (Duvoid, Urabeth, Urecholine)
• ipratropium (Atrovent)
• glaucoma medicines
• medicines for irritable bowel disease, myasthenia gravis, ulcers, or urinary problems (oxybutynin, tolterodine)
• other medicines used to treat Alzheimer’s or Parkinson’s disease 
• an anticholinergic medicine such as medicines to treat bladder or bowel spasms, or certain asthma medicines, or certain medicines to prevent motion or travel sickness
• metoclopramide
• beta blockers such as metoprolol (Toprol XL, Lopressor), carvedilol (Coreg), bisoprolol (Zebeta), nebivolol (Bystolic), and propranolol (Inderal)

Your doctor may need to change the doses of your medications or monitor you carefully for side effects. 

This is not a complete list of Exelon drug interactions. Ask your doctor or pharmacist for more information.

Exelon may cause serious side effects including:    

Capsules

• Stomach or bowel (intestinal) problems, including:
  • nausea  
  • vomiting 
  • diarrhea 
  • loss of appetite 
  • weight loss
  • bleeding in your stomach (ulcers) 

If treatment is interrupted for longer than several days, treatment should be reinitiated with the lowest daily dose to reduce the possibility of severe vomiting.

• Problems with movement (tremors) 

Patch

• Medication overdose. Hospitalization and rarely death may happen when people accidently wear more than 1 patch at the same time. It is important that the old Exelon Patch be removed before you apply a new one. Do not wear more than 1 Exelon Patch at a time.
• Stomach or bowel (intestinal) problems, including:
  • nausea  
  • vomiting 
  • diarrhea 
  • loss of appetite 
  • weight loss 
  • bleeding in your stomach (ulcers) 

If treatment is interrupted for longer than several days, treatment should be reinitiated with the lowest daily dose to reduce the possibility of severe vomiting.

• Skin reactions. Some people have had a serious skin reaction called allergic contact dermatitis (ACD) when using Exelon Patch. Stop using Exelon Patch and call your healthcare provider right away if you experience reactions that spread beyond the patch size, are intense in nature and do not improve within 48 hours after the patch is removed. Symptoms of ACD may be intense and include:
  • itching, redness, swelling, warmth or tenderness of the skin
  • peeling or blistering of the skin that may ooze, drain or crust over
• Heart problems 
• Seizures 
• Problems with movement (tremors) 

Do not touch your eyes after you touch the Exelon Patch. In case of accidental contact with your eyes or if your eyes become red after handling the patch, rinse immediately with plenty of water and seek medical advice if symptoms do not resolve.

Avoid exposure to heat sources such as excessive sunlight, saunas, or sun-rooms for long periods of time.

Exelon can cause drowsiness, dizziness, weakness, or fainting. Do not drive, operate heavy machinery, or do other dangerous activities until you know how Exelon affects you.

Do not take Exelon if you are allergic to any of the ingredients Exelon. 

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Exelon there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking Exelon, tell your doctor about all of your medical conditions. Especially tell your doctor if:

• you are allergic to Exelon, neostigmine (Prostigmin), physostigmine (Antilirium, Isopto Eserine), pyridostigmine (Mestinon, Regonol), any other medications, or any of the ingredients in Exelon
• have or have had problems with your heart such as an irregular heartbeat 
• you have, or ever had an active stomach ulcer.
• you have, or ever had difficulties in passing urine.
• you have, or ever had seizures.
• you have, or ever had asthma or a severe respiratory disease.
• you have a low body weight.
• have a loss of appetite or are losing weight 
• you have impaired liver function.
• have problems with movement (tremors) 
• have any other medical conditions
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Exelon
• are pregnant or plan to become pregnant. It is not known if the medicine in Exelon will harm your unborn baby. Talk to your healthcare provider if you are pregnant or plan to become pregnant.
• are breastfeeding or plan to breastfeed. It is not known if the medicine in Exelon passes into your breast milk. You and your healthcare provider should decide if you will use Exelon or breastfeed. You should not do both.

Tell your doctor about all the medicines you take including prescripiton and non-prescription medicines, vitamins, and herbal supplements. 

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Exelon falls into category B. There are no well-done studies that have been done in humans with Exelon. But in animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

It is not known if Exelon crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using Exelon.

Capsule:

• Use Exelon capsules exactly as your healthcare provider tells you to use it
• Exelon comes as a capsule form to take by mouth. It is usually taken twice a day with meals in the morning and evening. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Exelon exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor will start you on a low dose of Exelon and slowly increase your dose, but not more than once every 2 weeks.
• Exelon may improve the ability to think and remember or slow the loss of these abilities, but does not cure Alzheimer's disease or dementia in people with Parkinson's disease. Continue to take Exelon even if you feel well. Do not stop taking Exelon without talking to your doctor.

Patch:

• Use Exelon patch exactly as your healthcare provider tells you to use it.
• Your doctor will tell you which Exelon Patch is suitable for you. Treatment usually starts with Exelon Patch 4.6 mg/24 hours, and after several weeks many patients move to Exelon Patch 9.5 mg/24 hours as the usual daily dose. Apply the correct dose as directed by your doctor.
• The patch should be replaced by a new one after 24 hours. You must remove Exelon Patch from the previous day before applying a new one. Do not cut the patch into pieces.
• Having more than 1 Exelon Patch on your body at the same time can cause you to get too much medicine. 
• You may write the date and time you put on the Exelon Patch with a ballpoint pen before applying the patch to help you remember when to remove it.
• During the course of treatment, your doctor may adjust the dose to suit your individual needs.
• If you have forgotten to apply Exelon Patch, apply a new patch immediately. You may apply the next patch at the usual time the next day. Do not apply two Exelon patches to make up for the one that you missed. If you have not been applying Exelon Patch for several days, do not apply the next patch before you have talked to your doctor.
• Bathing, swimming, or showering should not affect the patch. 
• Check to see if the Exelon Patch has become loose when you are bathing, swimming, or showering.
• Exelon Patch is designed to deliver medication during the time it is worn. If your Exelon Patch falls off before its usual replacement time, put on a new Exelon Patch right away. Replace the new patch the next day at the same time as usual. Do not use overlays, bandages, or tape to secure an Exelon Patch that has become loose or try to reapply an Exelon Patch that has fallen off. 
• If you miss a dose or forget to change your Exelon Patch apply your next Exelon Patch as soon as you remember. Do not apply 2 Exelon Patches to make up for the missed dose.
• If you miss more than 3 doses of applying Exelon Patch, call your healthcare provider before putting on a new Exelon Patch. You may need to restart Exelon Patch at a lower dose.
• The patch should not be exposed to any external heat sources (excessive sunlight, saunas, solariums) for long periods of time.

Where to apply the patch:

• ​Apply the patch to the upper or lower back if it is likely that the patient will remove it. If this is not a concern, the patch can be applied instead to the upper arm or chest. Avoid places where the patch can be rubbed off by tight clothing.
• Before you apply Exelon Patch, make sure that your skin is:
  • clean, dry and hairless
  • free of any powder, oil, moisturizer, or lotion (that could keep the patch from sticking to your skin properly)
  • free of cuts, rashes and/or irritations
• When changing the patch, apply a new patch to a different spot of skin (for example on the right side of the body one day, then on the left side the next day). Do not apply a new patch to that same spot for at least 14 days. Apply the correct dose as directed by your doctor. The patch should be replaced by a new one after 24 hours.

How to apply the patch:

• The patch is a thin, opaque, plastic patch that sticks to the skin. Each patch is sealed in a pouch that protects it until you are ready to put it on. Do not open the pouch or remove a patch until just before you apply it.
• Cut the pouch along the dotted line and remove the patch.The patch should not be cut or folded sharply.
• A protective liner covers the adhesive side of the patch. Peel off one side of the protective liner and do not touch the sticky part of the patch with the fingers.
• Put the sticky side of the patch on the upper or lower back, upper arm or chest and then peel off the second side of the protective liner.
• Press the patch firmly in place with the hand to make sure that the edges stick well.
• You may write (e.g., the day of the week) on Exelon Patch with a thin ball point pen.
• Exelon Patch should be worn continuously until it is time to replace it with a new patch. Avoid placing the patch where it could be rubbed off by clothing.

​How to dispose of the patch:

• After the patch has been removed, fold it in half with the adhesive sides on the inside and press them together. Return the used patch to its original pouch and discard safely out of the reach and sight of children and pets as there may be medicine left over in the patch. Wash your hands with soap and water after removing the patch.      

Take this medicine exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose you doctor recommends may be based on the following:

• the condition being treated
• how you respond to the medication
• body weight
• liver function

Capsule:

The dose range of Exelon capsules in Alzheimer’s disease is 6 mg to 12 mg per day divided into 2 doses. (3 mg -6 mg twice a day)

The dose range of Exelon capsules in Parkinson’s disease is 6 mg to 12 mg per day divided into 2 doses. (3 mg -6 mg twice a day)

Patch:

The recommended starting dose to treat Alzheimer's and Parkinson's disease is the Exelon 4.6 mg/24 hours patch. A minimium of 4 weeks of treatment is required before increasing the dose to 9.5 mg/24 hours patch. 

Some patients require 13.3 mg/24 hours once daily. 

If you have taken too much Exelon (more than the prescribed amount) call your local Poison Control Center or seek emergency medical attention right away.

• If you accidentally apply more Exelon patches than you should, remove all Exelon patches from your skin, and then inform your doctor that you have accidentally applied more Exelon patches than you should have. You may require medical attention. Some people who have accidentally taken too much Exelon have experienced nausea, vomiting, diarrhea, high blood pressure and hallucinations. Slow heartbeat and fainting may also occur.

Capsule:

• Store Exelon capsules at controlled room temperature in a tight container.

Patch:

• Store Exelon patches between 59-86°F (15-30°C)
• Keep Exelon patches in the sealed pouch until ready to use.
• Do not use Exelon Patch after the expiration date shown on the carton and pouch.
• Keep this and all medicines out of the reach of children.