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What is Hetriva Patch?

Hetriva is a patch you apply once a day to improve memory, thinking, and behavior in people with mild to moderate dementia from Alzheimer’s or Parkinson’s disease.

Site of Application

• You can apply the Hetriva patch to your upper back, chest, or upper arm. It should be applied once a day.

Dosage & Administration

The typical dosage is as follows:

• Initiate: 9 mg patch
• Maintenance: 18 mg patch (after 4 weeks)
• Continue: 27 mg patch (after 4 weeks)

Storage & Precautions

Storage:

Store the patch in a cool, dry place below 25°C and keep it sealed until use.

Additional Precautions:

• Keep out of reach of children.
• Do not apply on broken, inflamed, or scarred skin.
• Replace immediately if a patch falls off.
• If missed for more than 3 days, consult your doctor.
• Tell your doctor if pregnant, breastfeeding, or have other health problems.
• Do not use if allergic to rivastigmine or similar patches.

Benefits

• Supports memory and daily functioning
• Improves thinking and attention
• Reduces confusion and behavioral changes
• Fewer stomach side effects than oral pills
• Easy once-daily use
• Continuous delivery for steady cognitive support

Product Overview:

The Hetriva Transdermal Patch is a brand of Rivastigmine, a medicine used to treat dementia.

Composition: Each patch contains Rivastigmine in dosages of 9, 18, and 27 mg.

Mechanism of Action:

• Dual inhibition: Rivastigmine blocks both acetylcholinesterase and butyrylcholinesterase, boosting acetylcholine levels in the brain and improving cognitive function.

Pharmacokinetics:

• Bioavailability: About 60-72% of the medicine is absorbed into the body.
• Metabolism: The medicine is processed by the liver.
• Elimination: The body gets rid of the medicine in about 2 hours, and 97% of it is excreted in urine.

Dosing & Administration:

The Hetriva patch is prescribed in a step-up or "titration" process:

• Start: Use the 9 mg patch to begin treatment.
• Maintenance: After 4 weeks, the dosage is increased to the 18 mg patch.
• Continue: After another 4 weeks, the dosage can be increased to the 27 mg patch.

Note: For severe GI side effects or if treatment is missed >3 days, pause or restart with the 9 mg patch.

Switching from Oral to Patch

• For patients on low oral dose (< 6 mg/day):Switch directly to 9 mg patch.
• For patients on higher oral dose (6–12 mg/day): Switch directly to 18 mg patch.

Contraindications:

• Hypersensitivity: History of reaction to carbamate derivatives
• Skin reactions: History of allergic dermatitis to patches
• Hepatic/Renal impairment: Use with caution in severe cases
• Pregnancy: Use only if potential benefit outweighs risk
• Breastfeeding: Use only if potential benefit outweighs risk
• Cardiac conduction abnormalities: Monitor closely

Drug Interactions:

• Avoid concomitant use with other cholinesterase inhibitors
• Use caution with drugs like digoxin, diazepam, warfarin, or fluoxetine due to potential interactions.

Clinical Evidence

• RCTs confirm improved cognition and daily functioning in Alzheimer’s and Parkinson’s dementia.
• Patch shows ~30–40% fewer GI side effects compared to oral rivastigmine.
• Demonstrates higher adherence (>70%) versus oral formulations (~50%).
• Well-tolerated with sustained efficacy in long-term therapy.

Storage & Handling

• Storage: Store at 20–25°C in a dry place.
• Dispose of used patches responsibly
• Keep sealed until use to prevent drug loss

Patient Suitability

• Mild to moderate Alzheimer’s or Parkinson’s dementia.
• Patients unable to swallow pills.
• Those needing steady once-daily therapy with better GI tolerance.

Supporting Tools & Resources

• Patient Guides: Patch application & titration instructions
• Monitoring Charts: Track cognition & daily function
• Clinic Posters: Reinforce adherence & caregiver education
• Mantra Bot: Smart reminders & adherence tracking for your patients