Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Exelon Patch 15 (Rivastigmine-transdermal). If you are concerned about side effects, discuss the risks and benefits of Exelon Patch 15 (Rivastigmine-transdermal) with your doctor.

The following side effects have been reported by at least 1% of people taking Exelon Patch 15 (Rivastigmine-transdermal). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• accidental falls
• agitation or confusion
• anxiety
• Constipation
• dehydration
• Diarrhea
• dizziness
• drowsiness
• fatigue
• general feeling of discomfort or illness
• headache
• increased sweating
• itching, irritation, or redness at site of patch application
• loss of appetite
• nausea
• nightmares
• stomach discomfort after a meal
• stomach pain
• trembling
• trouble sleeping
• Urinary Incontinence
• vomiting
• weakness
• weight loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• chest pain
• dehydration (losing too much fluid)
• fainting
• hallucinations (seeing, feeling, or hearing things that are not there)
• high blood pressure
• restlessness
• signs of Anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
• signs of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• skin rash or itching
• stiff limbs, trembling hands, body spasms
• symptoms of a stomach ulcer (e.g., stomach pain, burning, discomfort, or bloating)
• symptoms of a urinary tract infection (e.g., painful or burning urination, frequent urination, or cloudy urine)
• worsening Parkinson's Disease symptoms

Stop taking the medication and seek immediate medical attention if any of the following occur:

• blistering of the skin, mouth, eyes, or genitals
• blood in stools or when vomiting
• convulsions (seizures)
• fast, slow, or irregular heartbeat
• severe confusion
• severe vomiting
• signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with Fever or discomfort
• signs of bleeding in the stomach (e.g., bloody, black, or  tarry stools, spitting up of blood, vomiting blood or material that looks like coffee grounds)
• symptoms of a heart attack (e.g., pain, pressure, or discomfort in the chest, neck, back, or jaw; sweating; shortness of breath; nausea; lightheadedness; or feelings of anxiety, fear, or denial)
• symptoms of a Stroke (e.g., sudden paralysis or numbness, difficulty speaking or understanding speech, loss of coordination, severe headache, or vision changes)
• symptoms of inflammation of the pancreas (e.g., severe stomach pain with nausea and vomiting)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Exelon Patch 15 (Rivastigmine-transdermal).

Exelon Patch 5
Each patch of 5 cm² contains 9 mg of rivastigmine base, with in vivo release rate of 4.6 mg/24 hours. The outside of the backing layer is beige and labelled with "PrEXELON* PATCH 5 (rivastigmine) 4.6 mg/24 h" and "AMCX". Nonmedicinal ingredients: acrylic copolymer, poly (butylmethacrylate, methyl-methacrylate), silicone adhesive applied to a flexible polymer backing film, silicone oil, and vitamin E.

Exelon Patch 10
Each patch of 10 cm² contains 18 mg of rivastigmine base, with in vivo release rate of 9.5 mg/24 hours. The outside of the backing layer is beige and labelled with "PrEXELON* PATCH 10 (rivastigmine) 9.5 mg/24 h" and "BHDI". Nonmedicinal ingredients: acrylic copolymer, poly (butylmethacrylate, methyl-methacrylate), silicone adhesive applied to a flexible polymer backing film, silicone oil, and vitamin E.

Exelon Patch 15
Each patch of 15 cm² contains 27 mg of rivastigmine base, with in vivo release rate of 13.3 mg/24 hours. The outside of the backing layer is beige and labelled with "PrEXELON* PATCH 15 (rivastigmine) 13.3 mg/24 h" and "CNFU". Nonmedicinal ingredients: acrylic copolymer, poly (butylmethacrylate, methyl-methacrylate), silicone adhesive applied to a flexible polymer backing film, silicone oil, and vitamin E.

Do not use rivastigmine patch if you:

• are allergic to rivastigmine or any ingredients of the medication
• are allergic to medications that are similar to rivastigmine
• have had a severe skin reaction when using rivastigmine patches
• have severely reduced liver function

There may be an interaction between rivastigmine and any of the following:

• alcohol
• aclidinium
• Amiodarone
• antihistamines (e.g., brompheniramine, Chlorpheniramine)
• antipsychotic medications (e.g., Aripiprazole, Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine)
• atropine
• azelastine
• belladonna
• Benztropine
• beta-blockers (e.g., Atenolol, Metoprolol, Propranolol)
• Ceritinib
• cholinergic medications (e.g., Bethanechol)
• Clonidine
• corticosteroids (e.g., Dexamethasone, Hydrocortisone, Prednisone)
• Cyclobenzaprine
• Darifenacin
• Digoxin
• Diltiazem
• Dipyridamole
• Disopyramide
• Donepezil
• Dronedarone
• Fingolimod
• Flavoxate
• Galantamine
• glycopyrrolate
• Guanfacine
• ipratropium
• Ivabradine
• ketotifen
• Lacosamide
• Lanreotide
• methyldopa
• Metoclopramide
• Moclobemide
• neuromuscular blocking agents (e.g., atracurium, pancuronium, succinylcholine)
• Octreotide
• orphenadrine
• Oxybutynin
• Pasireotide
• Propafenone
• quinidine
• scopolamine
• succinylcholine
• tiotropium
• Tizanidine
• Tofacitinib
• Tolterodine
• Tranylcypromine
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• umeclidinium

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Exelon Patch 15 (Rivastigmine-transdermal). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Exelon Patch 15 (Rivastigmine-transdermal).

Breathing conditions: Rivastigmine may cause breathing problems to worsen. If you have a history of Asthma or obstructive lung disease (e.g., emphysema, chronic Bronchitis), discuss with your doctor how Exelon Patch 15 (Rivastigmine-transdermal) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Exelon Patch 15 (Rivastigmine-transdermal), and whether any special monitoring is needed.

Drowsiness/reduced alertness: Exelon Patch 15 (Rivastigmine-transdermal) may cause dizziness or drowsiness, mainly when starting treatment or increasing the dose. Your doctor will advise you whether it is safe for you to drive vehicles and operate machinery. If you feel dizzy or drowsy, do not drive, use machines, or perform any other tasks that require your attention.

Heart disease: People with certain types of heart disease (e.g., Congestive Heart Failure, Coronary Artery Disease) are more likely to experience symptoms of heart disease as a result of rivastigmine slowing down the heart rate. If you have heart disease, discuss with your doctor how Exelon Patch 15 (Rivastigmine-transdermal) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Exelon Patch 15 (Rivastigmine-transdermal), and whether any special monitoring is needed.

Incorrect use of medication: Rivastigmine patches are intended to be worn one at a time. Forgetting to remove a patch and applying a second one, can lead to severe, sometimes fatal side effects. If you experience nausea, vomiting, diarrhea, hallucinations, high blood pressure, decreased heart rate or falls, when you previously have tolerated the medication well, this may indicate an incorrect use of the patches.  Report any unusual side effects to your doctor as soon as possible.

Kidney function: If you have reduced kidney function or Kidney Disease, discuss with your doctor how Exelon Patch 15 (Rivastigmine-transdermal) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Exelon Patch 15 (Rivastigmine-transdermal), and whether any special monitoring is needed.

Liver function: Decreased liver function or liver disease can lead to Exelon Patch 15 (Rivastigmine-transdermal) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Exelon Patch 15 (Rivastigmine-transdermal) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Exelon Patch 15 (Rivastigmine-transdermal), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Exelon Patch 15 (Rivastigmine-transdermal). People with severely reduced liver function should not use Exelon Patch 15 (Rivastigmine-transdermal).

Low body weight: People who weigh less than 50 kg may experience more side effects than people who weigh more than 50 kg. Discuss with your doctor any concerns you may have about using the rivastigmine patch.

Seizures: People who have a history of seizures may experience an increase in seizures when using rivastigmine patch. If you have a history of seizures, discuss with your doctor how Exelon Patch 15 (Rivastigmine-transdermal) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Exelon Patch 15 (Rivastigmine-transdermal), and whether any special monitoring is needed.

Stomach problems: The use of rivastigmine patch is associated with significant stomach side effects including diarrhea, nausea, vomiting, loss of appetite, and weight loss. If these side effects persist or they bother you, speak to your doctor. If you have a history of stomach ulcers or are at risk of developing ulcers, discuss with your doctor how Exelon Patch 15 (Rivastigmine-transdermal) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Exelon Patch 15 (Rivastigmine-transdermal), and whether any special monitoring is needed.

Stopping and restarting treatment: If you miss more than 3 days' worth of treatment, talk to your doctor about how to safely restart the medication.

Surgery: Rivastigmine increases the effects of some medications that are used during surgery. If you are going to have surgery, make sure you let all the doctors, including dentists, know that you are using rivastigmine patch.

Pregnancy: Exelon Patch 15 (Rivastigmine-transdermal) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Exelon Patch 15 (Rivastigmine-transdermal), contact your doctor immediately.

Breast-feeding: It is not known if rivastigmine passes into breast milk. If you are a breast-feeding mother and are taking Exelon Patch 15 (Rivastigmine-transdermal), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Exelon Patch 15 (Rivastigmine-transdermal) have not been established for children.