Pancreatitis by transdermal rivastigmine (EXELON): Following two NETZWERK reports of severe pancreatitis in association with oral use of the cholinesterase inhibitor rivastigmine (EXELON; cf. a-t 2002; 33: 66), a third report now concerns the patch. After four weeks of use an 85-year old patient dies of pancreatitis (NETZWERK report 15.076). In the German prescribing information, it is stated that pancreatitis "has been observed only with oral EXELON (...) and not in clinical studies" of transdermal rivastigmine (Novartis: prescribing information EXELON transdermal patch, Sept. 2007). According to the American prescribing information (July 2007), in contrast, inflammation of the pancreas occurred in clinical studies with the patch with an incidence of 0.1% to 1%. Novartis has failed to give a clear answer to our query as to how many cases of pancreatitis are known in association with the transdermal formulation of the anti-dementia agent (letter of 11 Sept. 2008). The Medicines Committee of the German Medical Association (AkdÄ) has received one report of nonfatal pancreatitis with the patch among ten reports all together of pancreatitis with rivastigmine (AkdÄ: letter of 22 Sept. 2008).