The Department of Health and Social Care has issued a medicines supply notification for rivastigmine 4.6 mg/24 hours and 9.5 mg/24 hours transdermal patches.

Rivastigmine 13.3 mg/24 hours patches remain available but cannot support increased demand.

Actions for prescribers

• Do not initiate new patients on rivastigmine patches until supply issue is resolved.
• Review existing patients to ensure continuity of supply and avoid abrupt cessation. 
• Prioritise patches for patients unable to tolerate oral therapy (swallowing or GI effects).
• Where appropriate, consider oral rivastigmine (see supporting information for dose conversion), taking into account treatment history.
• If the above options are unsuitable, consider unlicensed supply of rivastigmine patches (see supporting information).  
• Seek specialist advice if the above options have been considered and unsuitable for further treatment options including once daily donepezil if the twice daily dosing regimen of oral rivastigmine is inconvenient for patients/carers.

For further details on the shortage, clinicians should refer to the Specialist Pharmacy Service Medicines Supply Tool MSN 2025/062.

ScriptSwitch® messages have been enabled to provide information on this shortage to support primary care.