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The product code(s) for this leaflet is: PL08553/0506.
Alzest 4.6 mg/24h, 9.5 mg/24h Transdermal Patch
Alzest 4.6 mg/24 h Transdermal Patch
Alzest 9.5 mg/24 h Transdermal Patch
Rivastigmine
1. What Alzest is and what it is used for
2. What you need to know before you use Alzest
3. How to use Alzest
4. Possible side effects
5. How to store Alzest
6. Contents of the pack and other information
The active substance of Alzest is rivastigmine.
Rivastigmine belongs to a class of substances called cholinesterase inhibitors. In patients with Alzheimer’s dementia, certain nerve cells die in the brain, resulting in low levels of the neurotransmitter acetylcholine (a substance that allows nerve cells to communicate with each other). Rivastigmine works by blocking the enzymes that break down acetylcholine: acetylcholinesterase and butyrylcholinesterase. By blocking these enzymes, rivastigmine allows levels of acetylcholine to be increased in the brain, helping to reduce the symptoms of Alzheimer’s disease.
Alzest is used for the treatment of adult patients with mild to moderately severe Alzheimer’s dementia, a progressive brain disorder that gradually affects memory, intellectual ability and behaviour.
If this applies to you, tell your doctor and do not apply Alzest transdermal patches.
Talk to your doctor before using Alzest
If any of these apply to you, your doctor may need to monitor you more closely while you are on this medicine.
If you have not applied a patch for more than three days, do not apply the next one before you have talked to your doctor.
There is no relevant use of Alzest in the paediatric population in the treatment of Alzheimer’s disease.
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Alzest might interfere with anticholinergic medicines some of which are medicines used to relieve stomach cramps or spasms (e.g. dicyclomine), to treat Parkinson’s disease (e.g. amantadine) or to prevent motion sickness (e.g. diphenhydramine, scopolamine, or meclizine).
Alzest should not be given at the same time as metoclopramide (a medicine used to relieve or prevent nausea and vomiting). Taking the two medicines together could cause problems such as stiff limbs and trembling hands.
If you have to undergo surgery whilst using Alzest transdermal patches, tell your doctor that you are using them because they may exaggerate the effects of some muscle relaxants during anaesthesia.
Caution when Alzest is given together with beta-blockers (medicines such as atenolol used to treat hypertension, angina, and other heart conditions). Taking the two medicines together could cause problems such as slowing of the heartbeat (bradycardia) leading to fainting or loss of consciousness.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
If you are pregnant, the benefits of using Alzest must be assessed against the possible effects on your unborn child. Alzest should not be used during pregnancy unless clearly necessary.
You should not breast-feed during treatment with Alzest transdermal patches.
Your doctor will tell you whether your illness allows you to drive vehicles and use machines safely. Alzest transdermal patches may cause fainting or severe confusion. If you feel faint or confused do not drive, use machines or perform any other tasks that require your attention.
Always use Alzest transdermal patches exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
Your doctor will tell you which Alzest transdermal patch is most suitable for you.
During the course of the treatment your doctor may adjust the dose to suit your individual needs.
If you have not applied a patch for more than three days, do not apply the next one before you have talked to your doctor. Transdermal patch treatment can be resumed at the same dose if treatment is not interrupted for more than three days. Otherwise your doctor will restart your treatment on Alzest 4.6 mg/24 h.
Alzest can be used with food, drink and alcohol.
Every 24 hours take off the previous patch before putting ONE new patch on to ONLY ONE of the following possible locations.
When changing the patch, you must remove the previous day’s patch before you apply the new one to a different location of skin each time (for example on the right side of your body one day, then on the left side the next day, and on your upper body one day, then on your lower body the next day). Do not apply a new patch to the same skin area twice within 14 days.
Alzest patches are thin, tan coloured, plastic patches that stick to the skin. Each patch is sealed in a sachet that protects it until you are ready to put it on. Do not open the sachet or remove a patch until just before you apply it.
Carefully remove the existing patch before putting on a new one.
For patients starting treatment for the first time and for patients restarting rivastigmine after treatment interruption, please begin with the second picture.
Each patch is sealed in its own protective sachet. You should only open the sachet when you are ready to apply the patch.
Cut the sachet at both scissors marks, but not further than the indicated line. Tear the sachet to open. Do not cut the entire length of the sachet in order to avoid damaging of the patch.
Remove the patch from the sachet.
Remove the cover sheet from the top, skin-coloured side of the patch and discard it.
A protective liner covers the sticky 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 or upper arm or chest and then peel off the second side of the protective liner.
Then press the patch firmly in place for at least 30 seconds using the palm of the hand to make sure that the edges stick well.
If it helps you, you may write, for example, the day of the week, on the patch with a thin ball point pen.
The patch should be worn continuously until it is time to replace it with a new one. You may wish to experiment with different locations when applying a new patch, to find ones that are most comfortable for you and where clothing will not rub on the patch.
Gently pull at one edge of the patch to remove it slowly from the skin. In case the adhesive residue is left over on your skin, gently soak the area with warm water and mild soap or use baby oil to remove it. Alcohol or other dissolving liquids (nail polish remover or other solvents) should not be used.
You should wash your hands with soap and water after removing the patch. In case of contact with eyes or if the eyes become red after handling the patch, rinse immediately with plenty of water and seek medical advice if symptoms do not resolve.
If a patch falls off, apply a new one for the rest of the day, then replace it at the same time as usual the next day.
If you accidentally apply more than one patch, remove all the patches from your skin, then inform your doctor that you have accidentally applied more than one patch. You may require medical attention. Some people who have accidentally taken too much rivastigmine have experienced feeling sick (nausea), being sick (vomiting), diarrhoea, high blood pressure and hallucinations. Slow heart beat and fainting may also occur.
If you find you have forgotten to apply a patch, apply one immediately. You may apply the next patch at the usual time the next day. Do not apply two patches to make up for the one that you missed.
Tell your doctor or pharmacist if you stop using the patch.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Like all medicines, Alzest transdermal patches can cause side effects, although not everybody gets them.
You may have side effects more often when you start your medicine or when your dose is increased. Usually, the side effects will slowly go away as your body gets used to the medicine.
Common (may affect up to 1 in 10 people)
Uncommon (may affect up to 1 in 100 people)
Rare (may affect up to 1 in 1,000 people)
Very rare (may affect up to 1 in 10,000 people)
Not known (frequency cannot be estimated from the available data)
Take off your patch and tell your doctor straight away, if you notice any of the side effects above.
Common (may affect up to 1 in 10 people)
Uncommon (may affect up to 1 in 100 people)
Rare (may affect up to 1 in 1,000 people)
Very rare (may affect up to 1 in 10, 000 people)
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme, website www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.
Each transdermal patch is a thin patch. The outer layer is tan coloured and printed with an orange printing ink as following:
One transdermal patch is sealed in one sachet. The patches are available in packs containing 7, 30 or 42 sachets and in multipacks containing 60, 84 or 90 sachets.
Not all pack sizes may be marketed.
This leaflet was last revised in 03/2016