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All About Exelon

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Updated March 04, 2009

What It Is:

A commonly used drug to treat the symptoms of Alzheimer's disease. Exelon is FDA approved for mild and moderate stages of the disease; it is also approved for the treatment of mild to moderate dementia due to Parkinson's disease.

How It Works:

Exelon is a cholinesterase inhibitor that prevents the breakdown of acetylcholine and butyrylcholine in the brain by blocking the activity of two different enzymes. Acetylcholine and butyrylcholine play a key role in memory and learning; higher levels in the brain help nerve cells communicate more efficiently.

Effectiveness:

Exelon postpones the worsening of Alzheimer's symptoms for 6 to 12 months in about half of the people who take it. For many, the improvement is minimal, yet worthwhile. Anecdotal evidence suggests that a small percentage of people may benefit more dramatically from this drug.

Dosage:

Exelon is available as a capsule, liquid, and patch. In capsule or liquid form, it's commonly started at 1.5 mg twice a day; if it's well-tolerated, the capsule or liquid dosage is increased by 3 mg a day every two weeks until the dosage reaches 6 mg twice a day. In patch form, a 4.6 mg, 5 cm patch is worn once a day for 4 weeks. If it's well-tolerated, the dosage may be increased to a 9.5 mg, 10 cm patch once a day. Your healthcare professional will determine the best dosage for you or your loved one.

Side Effects:

The most common side effects of Exelon are nausea, diarrhea, increased frequency of bowel movements, vomiting, muscle weakness, loss of appetite, weight loss, dizziness, drowsiness, and upset stomach. People who weigh less than 110 pounds may experience more severe side effects and may need to stop taking Exelon.

Potential Interactions:

Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, should be used with caution while taking Exelon, due to the increased risk of stomach ulcers. Exelon shouldn't be taken concurrently with similar medications or anticholinergic drugs (some antidepressants, antipsychotics, and antihistamines, for example).

Precautions:

Exelon shouldn't be used by anyone who's had an allergic reaction to rivastigmine or a similar medication. Be sure to tell your doctor about any history or current problems with stomach ulcers, including any current medications being taken for a stomach condition. If you have a heart condition or are at risk for heart disease, be sure to tell your doctor before taking Exelon, as you may experience fainting. Also, if you have a serious lung condition, bladder problems, or seizures, tell your doctor before taking Exelon.

Manufacturer:

Exelon is manufactured by Novartis Pharmaceuticals.

Generic Available:

Exelon will not be available in generic form until Novartis' patent expires in 2014.

Sources:

About Exelon for mild to moderate Alzheimer's dementia. Novartis Pharmaceuticals. 2008.

Alzheimer's disease medications fact sheet. Alzheimer's Disease Education and Referral Center, National Institute on Aging. January 15, 2008. http://www.nia.nih.gov/Alzheimers/Publications/medicationsfs.htm

FDA-approved treatments for Alzheimer's. Alzheimer's Association. July 2007. http://www.alz.org/national/documents/topicsheet_treatments.pdf

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