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Why is Exelon patch dosage reduced? - Online Doctor Chats

Date : 25-Mar-2014
User rating for this question
Very Good Posted in: Medicines and Side Effects
Answered by

General & Family Physician
Practicing since : 2003
Answered : 1560 Questions
User:My wife has been on Exelon patch for several years and went from an initial dose of 4.6 units per patch
to 13.3. Now the neurologist in FL is reducing it slowly to 9.5 and back to 4.6. and said it was because
of her low weight 117+-3 is her steady value height 5ft 7. When I look at the web about the Exelon patch
it mentions that it could cause weight LOSS. but not about the dosage for persons within weight RANGE
values. She is not losing weight, but is steady at about the 117 lb value. So I am concerned about the
reduction in the dosage.
Doctor:I have read your query
User:any comments on the question?
Doctor:I would say that if your wife is doing fine with dose reduction than it is ok and in fact better to reduce dose
User:but she was doing well at the 13.3 dose. and it seems the call for a reduction is made
User:the person is losing weight
Doctor:It is possible that the dose was reduced because the dose was high for her weight
User:yes that is the nature of the question. what is the proper dose for a person of 117 lbs.
Doctor:Mostly the medicines need to be titrated according to the safe dose and the symptoms of the patient and side effects
User:I ask because the only connection between dose on the Internet is in regards to weight loss. and this is not her problem.
Doctor:I understand your concern
Doctor:All medicines have a range of dose for a particular weight
User:yes I would think that is the case. and a Dr could look at a chart and see
User:what is the value for a person of 117lbs
Doctor:ok let me calculate it
Doctor:I think somewhere around 4.5 mg/d would be appropriate for her
Doctor:The insert for this medicine says that it should be taken with care if her weight becomes even less
Doctor:She may be losing weight due to the medicine
Doctor:Do you have a question here?
Doctor:Are you there?
User:yes I am here I am confused by your answer. because she is NOT losing weight but
User:is maintaining a steady weight near 117. and even at 13.3 dose she was NOT losing weight. Where can I look at the table that shows the proper dosage of the Exelon
User:patch versus weight.
Doctor:Such a graph wont be available
Doctor:I had to calculate roughly
Doctor:Seeing the maximum dose and minimum dose
Doctor:These doses are mostly for male of weight around 72 kg
User:whicd doses are for males of 72 kg.. just the highest one. I can do interpolation myself
User:and would like to see some values to work with
Doctor:Suppose if you download the insert by the company
Doctor:that makes the patch
Doctor:They have mentioned the starting dose and the maintenance dose
User:OK I will see if I can contact the company. It sure seems odd that she had been
Doctor:The maximum dose is 6 mg twice a day
Doctor:so your wife can take a maximum dose of 4.5 mg twice a day
User:increased to the 13.3 dose
Doctor:Sorry in my previous answer i mentioned 4.5 mg per day by mistake
Doctor:Maybe the doctor was titrating according to the symptoms
User:The patch is taken only once per day is my understanding.
Doctor:in the insert it is twice a day
Doctor:Please go through this link
User:hmmm pills are often taken multiple times per day but patches are usually extended
User:release and are put on only once per day
Doctor:Yes that is true
Doctor:in that case the maximum dose would be 9 mg per day
User:Thanks for the website address.
User:thanks also for your help. I have no other questions.
Doctor:Hope I was able to clear your doubts
Doctor:These calculations are complex
User:yes it was good "talking" to you
Doctor:Take care
Doctor:Same here
User:you also
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