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Exelon (rivastigmine) is an acetylcholinesterase inhibitor (AChEI) used in dementia associated with Alzheimer's or Parkinson's disease. It is not a cure and will not stop or reverse the condition, but it does slow progression and improve cognitive function.

The medication works by preserving the neurotransmitter acetylcholine, which helps brain cells communicate with each other. Acetylcholine levels are often low in patients with Alzheimer's or Parkinson's disease, though this is not the only factor that contributes to symptoms like memory loss.

Exelon is often paired with Namenda (also available in extended release tablets). Where Exelon works to improve communication between cells, Namenda works to protect the cells themselves. Improvements can be significantly improved when these medications are taken together, though as with any medication this should not be done without first consulting a doctor.

Improving Quality of Life with Exelon

Exelon comes as oral tablets or in patches. Patches are generally preferred as patients are less likely to experience side effects compared to tablets. Note that the information on this page refers to patches.

Patches are available in several dosage strengths. As a general rule, patients should start with lower doses and increase only if lower doses do not produce significant results. It takes about four weeks of treatment before full benefits will be seen; dosage modification should be done at least four weeks apart.

Exelon patches are meant to be changed once per day, ideally at the same time each day. New patches should be applied to clean, dry skin, and a new application site should be chosen each day to prevent skin irritation. Patches are generally waterproof and can be worn while bathing or showering, though it is possible a patch will become loosened. Patches that become loose or fall off should be replaced with a new patch. Never apply more than one patch at a time; too much of this medication can produce very serious side effects. Likewise never exceed 13.3 mg in a 24 hour period; this is the highest-strength patch.

In addition to slowing the progress of dementia, most patients experience improvements in a number of critical areas, including:

• Memory
• Attention/focus
• Comprehension
• Orientation
• Coordination
• Routine activities
• Socializing
• Speaking/communicating

These improvements have obvious benefits; patients are often able to retain their independence longer, reduce reliance on caretakers, and---most importantly---retain their sense of self and ability to interact meaningfully with loved ones.

Patients should understand that while Exelon will slow the progression of dementia, the medication will not stop its progression. There is currently no known cure for dementia associated with Alzheimer's or Parkinson's disease.

Before Starting Treatment

Patients with certain other medical conditions are at increased risk of experiencing potentially serious side effects from Exelon. Discuss risks carefully with a doctor if there is a history of:

• Liver or kidney impairment
• Any heart condition
• Difficulty urinating
• Seizures
• Asthma, COPD, or other chronic respiratory ailments
• Stomach ulcers
• Lack of appetite or major weight loss

Exelon is also known to interact with some other medications. Categories of most concern are:

• Beta-blockers
• Bronchodilators
• Antihistamines
• Urinary or bladder medications
• Certain Parkinson's disease medications
• Stomach medications to treat ulcers, motion sickness, and so forth
• Heartburn/GERD and similar medications

Many of the above medications are widely available over-the-counter. A doctor or pharmacist should be consulted before adding, removing, or combining any medications---no matter how innocuous-seeming---while taking Exelon.