Brand Name: Exelon
Drug Class: Reversible
Available in: Capsules,
Available OTC? No
As Generic? No
gastrointestinal bleeding. No other serious side effects are
associated with the use of rivastigmine.
nausea, vomiting, loss of appetite, and weight loss. Other
common side effects include heartburn, weakness, dizziness,
Less Common: Increased
sweating, fatigue, malaise, headache, drowsiness, tremor, flatulence,
insomnia, depression, anxiety.
To treat mild to moderate Alzheimer disease.
How the Drug Works
The exact mechanism of action is unknown. However,
rivastigmine is believed to work by inhibiting acetylcholinesterase
enzymes, which reduces the breakdown of acetylcholine, a brain
chemical crucial to memory. Acetylcholine deficiency is thought
to result in memory loss associated with Alzheimer disease.
To start, 1.5 mg twice a day. After two weeks of
treatment, your doctor may increase the dose to 3 mg twice a
day. The dose may be further increased at no less than 2-week
intervals to 4.5 mg twice a day and then to the maximum dose
of 6 mg twice a day, if tolerated.
Onset of Effect
Duration of Action
Rivastigmine should be taken with meals in the
morning and evening. The oral solution may be swallowed directly
from the syringe or mixed with a small glass of water, cold fruit
juice, or soda.
Store in a tightly sealed container away from heat,
moisture, and direct light. Do not freeze the oral solution.
If You Miss a Dose
Take it as soon as you remember, unless the time
for your next scheduled dose is within the next 2 hours. If so,
do not take the missed dose. Take your next scheduled dose at
the proper time and resume your regular dosage schedule. Do not
double the next dose. If therapy has been interrupted for several
days or longer, consult your physician.
Stopping the Drug
The decision to stop taking the drug should be
made in consultation with your physician.
No problems are expected with long-term use.
Over 60: No special
problems are expected.
Driving and Hazardous Work: Do
not drive or engage in hazardous work until you determine how
the medicine affects you.
Alcohol: Avoid alcohol
while using this medication.
Pregnancy: In some
animal studies, large doses of rivastigmine were shown to cause
problems. Before you take rivastigmine, tell your doctor if you
are pregnant or plan to become pregnant.
Breast Feeding: It
is not known whether rivastigmine passes into breast milk; caution
is advised. Consult your doctor for specific advice.
Infants and Children: Rivastigmine
is not intended for use in children.
Special Concerns: Before
you have any surgery or dental or emergency treatment, tell the
doctor or dentist in charge that you are taking rivastigmine.
Rivastigmine will not cure Alzheimer disease and will not stop
the disease from getting worse, but it will improve cognitive
ability of some patients. Caretakers should be instructed in
the correct way to administer the oral solution of rivastigmine.
Symptoms: Severe nausea,
vomiting, increased salivation, sweating, slow heartbeat, low
blood pressure, irregular breathing, unconsciousness, increased
muscle weakness, death.
What to Do: Call your
doctor, emergency medical services (EMS), or the nearest poison
control center immediately.
Nonsteroidal anti-inflammatory drugs (NSAIDs) may
increase the risk of peptic ulcer or gastrointestinal bleeding
when taken with rivastigmine.
No known food interactions.
Caution is advised when taking rivastigmine.
Consult your doctor if you
have any of the following: asthma, epilepsy or a history
of seizures, heart problems, intestinal blockage, stomach or
duodenal ulcer, liver disease, or urinary problems.
Johns Hopkins Consumer Guide to Drugs. You
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