Rivastigmine is a drug that may help people with Alzheimer’s disease improve thinking, memory, communication, and how they perform activities. It is a daily patch people wear on the skin.
Alzheimer‘s disease is the most common cause of dementia, a group of symptoms that can affect a person‘s ability to remember, think, converse, and complete daily tasks.
The brain health symptoms of Alzheimer’s disease tend to get worse over time, and currently, there is no cure available.
However, treatment can help improve the quality of life for people with Alzheimer‘s disease. One such treatment is rivastigmine, which the Food and Drug Administration (FDA) approved in 1997 for people with mild to moderate Alzheimer‘s disease.
This article explains how rivastigmine works, its side effects, and how to use it.
Rivastigmine belongs to a class of medications known as cholinesterase inhibitors.
Cholinesterase is an enzyme that works around the intersections between nerves and parts of the brain that process a lot of information, such as the cerebral cortex. The enzyme breaks down a natural compound called acetylcholine, which has links to brain function.
People with Alzheimer‘s disease and other forms of dementia show
Research shows that rivastigmine may be effective in managing some symptoms of Alzheimer‘s disease.
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However, only three studies reported a change in behaviors, and there were no significant behavioral differences between the rivastigmine group and those taking a placebo.
Rivastigmine works by transferring medications through the skin. Experts advise applying it to a clean, dry, mostly hairless area at the same time every day.
It is important to ensure the area:
- does not rub against tight clothing
- has no open wounds or rashes
- has not had a patch on it in the last 14 days
Steps for applying the rivastigmine patch
The steps for putting on a rivastigmine patch are as follows:
- Clean the area with soap and water, then rinse it off. Keep it clear of lotions or powders.
- Cut open the pouch containing the patch without cutting the patch.
- Remove the patch, keeping the sticky side facing away.
- Peel one side of the liner away, avoiding any contact between the fingers and the sticky side.
- Press the patch onto the skin, with the sticky side facing down.
- Remove the other side of the liner and press what remains of the sticky side into the skin.
- Wash both hands with soap and water after handling and applying the patch.
- Keep the patch on for 24 hours.
Steps for removing and replacing the rivastigmine patch
It is advisable to remove the patch using the following steps:
- After 24 hours of use, slowly peel off the patch using the fingers.
- Fold the patch in half, with the sticky sides facing inward.
- Dispose of the finished patch somewhere that children and pets cannot access it.
- Pick a different area for the next patch.
- Repeat steps 1–8 for application immediately.
- Apply a new patch if a patch falls off.
- Replace the new patch at the scheduled time intended for the original patch. For example, a person could apply the initial patch at 8 a.m., but it may fall off at 3 p.m. If this happens, replace the patch immediately and again at 8 a.m. the following morning.
It is vital to use rivastigmine exactly as a doctor instructs. It is advisable to avoid skipping days of rivastigmine doses without first speaking with a doctor.
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- gastrointestinal effects like nausea, vomiting, and diarrhea
- appetite loss
- headache
- dizziness
- weakness and fatigue
- sleep problems
- anxiety
- abdominal pain
- skin reactions at the patch site
- weight loss
Speak with a doctor if these persist or get worse. Severe side effects include:
- black, tarry stools
- stools that contain blood
- blood or a substance that resembles coffee grounds in the vomit
- difficulty or pain in passing urine
- seizures
Speak with a doctor immediately if these side effects develop.
Other medications that
- Other cholinesterase inhibitors: Drugs like donepezil (Aricept) and galantamine may help improve quality of life and comfort for people living with mild to moderate Alzheimer‘s disease. They work similarly to rivastigmine.
- Atypical antipsychotic medications: These may help reduce agitation. Brexpiprazole (Rexulti) is the approved antipsychotic medication for Alzheimer‘s in the United States.
- N-methyl-D-aspartate (NMDA) agonists: Medications such as memantine help preserve acetylcholine in the brain and lower the serious side effects of too much glutamate. Glutamate is a compound necessary for brain function, but too much can kill brain cells.
Currently, there is no cure for Alzheimer‘s. However, some immunotherapy drugs, such as lecanemab, can help the immune system target amyloid plaques in the brain that may play a role in Alzheimer‘s progression. This helps slow down memory loss.
Here are the most common questions about rivastigmine patches.
Do dementia patches work?
Rivastigmine patches
What patches help Alzheimer‘s?
The Rivastigmine patch became available for people with Alzheimer‘s in
Alzheimer’s and dementia resources
To discover more evidence-based information and resources for Alzheimer’s and dementia, visit our dedicated hub.
Rivastigmine is a cholinesterase inhibitor medication that helps reduce symptoms of mild to moderate Alzheimer‘s. The patch goes directly on the skin at the same time daily and can help improve memory and thinking.
Research shows that rivastigmine is effective compared with a placebo. However, the medication may cause side effects such as nausea, dizziness, vomiting, and diarrhea.
People may want to speak with a doctor to find out whether rivastigmine is right for them.