Select therapeutic use:

Alzheimer's dementia:

Indications for EXELON PATCH:

Treatment of dementia of the Alzheimer's type.

Adult:

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. Mild-to-moderate: usually 9.5mg/24hrs or 13.3mg/24hrs once daily. Severe: usually 13.3mg/24hrs once daily. If dosing interrupted for >3 days, restart with 4.6mg/24hrs patch and retitrate. 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/24hrs patch. Switching from capsules: 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. Nursing mothers.

See Also:

Pharmacologic Class:

Reversible acetylcholinesterase inhibitor (carbamate deriv).

Interactions:

Concomitant metoclopramide, beta-blockers, cholinomimetics, anticholinergics: not recommended. May potentiate succinylcholine-type muscle relaxants. Monitor for GI bleed with NSAIDs.

Adverse Reactions:

Nausea, vomiting, anorexia, dyspepsia, asthenia, diarrhea, abdominal pain, dizziness, weight loss, tremor, 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:

YES

How Supplied:

Caps—60, 500; Patches—30

Parkinsonism:

Indications for EXELON PATCH:

Mild-to-moderate dementia associated with Parkinson's disease.

Adult:

Take with food in the AM and PM. 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. Moderate-to-severe 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 retitrate. 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/24hrs patch. Switching from capsules: 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. Nursing mothers.

See Also:

Pharmacologic Class:

Reversible acetylcholinesterase inhibitor (carbamate deriv).

Interactions:

Concomitant metoclopramide, beta-blockers, cholinomimetics, anticholinergics: not recommended. May potentiate succinylcholine-type muscle relaxants. Monitor for GI bleed with NSAIDs.

Adverse Reactions:

Nausea, vomiting, anorexia, dyspepsia, asthenia, diarrhea, abdominal pain, dizziness, weight loss, tremor, 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:

YES

How Supplied:

Caps—60, 500; Patches—30