Rivastigmine Patches in the Treatment of Dementia

Rivastigmine is prescribed for the treatment of dementia. It's available in the form of transdermal patches with different doses of the active ingredient.
Rivastigmine Patches in the Treatment of Dementia

Last update: 02 June, 2021

Rivastigmine patches are made of a drug that doctors prescribe for the treatment of people who have dementia. This drug belongs to the group of cholinesterase inhibitors.

In dementia patients, part of their neurons die. As a consequence of this neuronal degeneration, the levels of a neurotransmitter called acetylcholine are lower than in people who don’t suffer from this disease.

What are Rivastigmine patches for and how do they work?

A digital image of the brain.

This drug for the treatment of dementia exerts its effect by blocking the enzymes responsible for the destruction of acetylcholine. In Alzheimer’s patients, acetylcholine levels are decreased. Among the enzymes responsible for the destruction of acetylcholine are acetylcholinesterase and butyrylcholinesterase.

Acetylcholine is a neurotransmitter that allows neurons to communicate with each other. When rivastigmine blocks the enzymes, it causes an increase in acetylcholine levels in the brain. Therefore, as a consequence of its mechanism of action, this drug helps to reduce the symptoms of Alzheimer’s disease.

What are the indications?

Rivastigmine patches are prescribed in the following cases:

  • Dementia: This is a disease that affects the ability to remember, think clearly, communicate, and perform daily activities.
  • Alzheimer’s disease: This is a disease that affects the brain and progressively destroys memory and the ability to think.
  • Dementia in people with Parkinson’s disease: Parkinson’s is a degenerative disease that affects the nervous system and dementia becomes evident throughout the course of the disease.

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How to start treatment with Rivastigmine patches

A stethestocope wrapped around a plastic model of the brain.

Rivastigmine comes in the form of transdermal patches and can contain different doses of the active substance. It’s necessary to use a patch every day, and of course, first remove the previous one.

To apply the patch correctly, stick the patch on and press with the palm of your hand for a few seconds. Normally, the starting dose of Rivastigmine treatment is 4.6 mg every 24 hours. However, the recommended daily dose to be reached is 9.5 mg every 24 hours.

If for some reason you have to stop treatment with Rivastigmine patches, you can resume using the patches again at the same dose you stopped. You can do this if no more than three days have passed since you stopped treatment.

However, if you stop treatment for longer than three days, you need to talk to your specialist for advice on how to start using the patches again.

Where do I apply the Rivastigmine patches?

Before applying a Rivastigmine patch for the treatment of dementia and making sure it sticks well, make sure the area is clean, dry, and free of hair. All of these factors can prevent the patch from sticking well and not having the desired effect.

As mentioned above, you can attach one patch per day to one of the following areas of the body:

  • Upper arm area, on the left or right side
  • Upper chest, on the left or right side
  • Lower back, on the left or right side
  • Upper back, on the left or right side

However, avoid placing the transdermal patch on the thigh and abdomen. Both the thigh and the abdomen are areas to avoid because the bioavailability of the active ingredient decreases when applied there and, therefore, its effect decreases as well.

It’s advisable to wait at least two weeks to repeat the skin area where you’re going to apply the patch. If a patch comes off, apply a new one, thus covering the daily dose.

Side effects of Rivastigmine patches

The most frequent adverse reactions are:

  • Gastrointestinal reactions: Among these reactions are some such as nausea, vomiting, or loss of appetite.
  • Skin reactions: Redness, itching, or irritation in the area where you applied the patch.

The occurrence of any of these adverse reactions depends on several factors, including:

  • Sensitivity of each patient
  • Weight of the person undergoing treatment
  • Dose of Rivastigmine being used

During treatment with rivastigmine patches, if you experience gastrointestinal adverse reactions such as those we mentioned above, you should discontinue treatment until the symptoms disappear.


In summary, rivastigmine may be useful in the treatment of people with Alzheimer’s disease. In general, the use of a transdermal patch has fewer side effects than treatment with orally administered drugs.

Consult your doctor for more information.

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