药物名称：Exelon
通用名称：卡巴拉丁
2012年9月2日 -- 诺华药物Exelon（卡巴拉丁透皮给药系统）获得来自FDA的新的适用剂量批准，旨在治疗轻度至中度的阿尔茨海默氏症患者。
在持续48周的双盲OPTIMA研究中，针对轻度至中度阿尔茨海默氏症的患者治疗，每24小时13.3mg的施用剂量相对每24小时9.5mg的施用剂量显著提高了患者的整体症状。研究采用工具性日常生活能力量表（ADCS-IADL）进行测量，在第48周达到了主要终点。
相比低剂量组，新的适用剂量在24周的实验中显著提升了患者的认知水平。48周的实验未获得显著数据，但也达到了主要终点。
克利夫兰脑健康诊所负责人Jeffrey Cummings表示，阿尔茨海默氏症的特点是病情会逐渐恶化，这对于患者及监护人的身体和情感都是一种挑战。
国家家庭监护人协会首席执行总裁John Schall表示，从监护人的角度考虑，新批准的剂量提供了可视的证据，他们可以看到心爱的人接受了更好的治疗。因此额外的治疗选择是非常必要的。
诺华制药主席Andre Wyss称，诺华公司相信头皮应用程序和这一新剂量的疗效，我们也在致力于阿尔茨海默氏症的新研究。
除了阿尔茨海默氏症，Exelon新的适用剂量也可用于治疗与阿尔茨海默氏症相关的帕金森病。

Generic Name: rivastigmine transdermal (riv a STIG meen)
Brand Names: Exelon
What is Exelon?
Exelon (rivastigmine) improves the function of nerve cells in the brain. Rivastigmine works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.
Exelon transdermal (skin patch) is used to treat mild to moderate dementia caused by Alzheimer's or Parkinson's disease.
Exelon may also be used for purposes not listed in this medication guide.
Important information about Exelon
You should not use Exelon if you are allergic to rivastigmine.
Before using Exelon, tell your doctor if you have liver disease, a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats), an enlarged prostate, urination problems, a seizure disorder, asthma or allergies, tremors or uncontrolled muscle movements, or a history of stomach ulcer.
Always remove an old patch before putting on a new one. Do not wear more than 1 patch at a time. Stop using Exelon and call your doctor at once if the medicine causes you to have nausea and vomiting, loss of appetite, or weight loss.
If you stop using Exelon for any reason, do not restart the medication without talking to your doctor first. You may need to restart treatment with a lower dose.
If you need surgery, tell the surgeon ahead of time that you are using Exelon.
Exelon may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Before using Exelon
You should not use Exelon if you are allergic to rivastigmine.
To make sure you can safely use Exelon, tell your doctor if you have any of these other conditions:
•liver disease;
•recent weight loss or lack of appetite;
•a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats);
•a history of stomach ulcer;
•an enlarged prostate or urination problems;
•epilepsy or other seizure disorder;
•asthma or any allergies; or
•tremors (dyskinesia) or uncontrolled muscle movements.
FDA pregnancy category B. Exelon is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether rivastigmine passes into breast milk or if it could harm a nursing baby. Do not use Exelon without telling your doctor if you are breast-feeding a baby.
See also: Exelon pregnancy and breastfeeding warnings (in more detail)
How should I use Exelon?
Use Exelon exactly as prescribed by your doctor. Do not apply more patches or use them for longer than recommended. Follow the directions on your prescription label.
Exelon comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
Never cut or tear a Exelon patch.
Apply the skin patch to a flat, hairless area of the chest, back, side, or outer side of your upper arm. Press the patch firmly with the palm making sure it sticks firmly, especially around the edges.
Avoid placing the Exelon patch where it will be rubbed by tight clothing, or in the folds of your skin. The patch should remain flat on the skin at all times. Take care to avoid accidentally removing the patch while showering or during physical activity.
You will wear the Exelon patch for 24 hours and then remove it and put on a new one. Apply the new patch to a different skin area on your back each day. Do not use the same spot again for at least 14 days.
Always remove an old Exelon patch before putting on a new one. Do not wear more than 1 patch at a time.
If a patch falls off, apply a new patch and wear it for the rest of the day. Change the patch at your usual time the next day.
After removing a Exelon skin patch fold it in half, sticky side in, and throw it away where children and pets cannot get to it.
Always wash your hands after removing the patch.
If you need surgery, tell the surgeon ahead of time that you are using Exelon. You may need to stop using the medicine for a short time.
It may take up to 4 weeks of using Exelon transdermal before your symptoms improve. For best results, keep using the patches as directed.
If you stop using Exelon for any reason, do not restart the medication without talking to your doctor first. You may need to restart treatment with a lower dose.
Store Exelon at room temperature away from moisture and heat. Keep each patch in its foil pouch until you are ready to use it.