Meds and you

Updated 11 February 2013

Rivastigmine

Rivastigmine is prescribed to treat mild to moderate dementia.

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Rivastigmine is the active ingredient of Exelon.

General information

Rivastigmine is prescribed to treat mild to moderate dementia - a progressive condition in which a person loses the ability to think, remember, learn, make decisions and solve problems - in Alzheimer's disease, and to slow down the deterioration in patients.

The medication may slow the rate of cognitive - conscious intellectual activity - and non-cognitive deterioration in an estimated 40% of patients.

For rivastigmine to be effective, it must be taken regularly. It is advised that patients should be assessed regularly to determine if treatment should be continued.

A so called 'drug-holiday' - a period during which treatment with the drug is stopped- is sometimes recommended to evaluate whether a patient is indeed responding to rivastigmine. Should the condition of an otherwise well controlled rivastigmine-patient deteriorate rapidly during a 6-week stoppage of the drug, continued treatment with rivastigmine advised.

The body weight of patients should be closely monitored as this drug may cause weight loss, particularly in female patients.

How does rivastigmine work?

Rivastigmine blocks an enzyme in the brain responsible for the breakdown of the chemical messenger acetylcholine. Acetylcholine is largely responsible for cognitive function, and a rise in acetylcholine often assists demented patients.

Fast facts

Drug schedule: schedule 5

Available as: this medication is available as capsules

What does it do? rivastigmine improves intellectual activity in patients with Alzheimer's disease

Overdose risk: medium

Dependence risk: low

Is rivastigmine available as a generic ? no

Is rivastigmine available on prescription only? yes

User information

Onset of effect : it may take a couple of months for the full effect of rivastigmine to be seen.

Duration of action: up to 12 hours.

Stopping this medicine: use rivastigmine as prescribed by your doctor, and do not discontinue treatment before speaking to your doctor - suddenly stopping the drug may cause symptoms to recur.

Prolonged use: The drug should be continued for as long as a benefit can be seen; it is advised that patients should be assessed regularly to determine if treatment should be continued.

Special precautions

Consult your doctor before using this drug if:

  • you have or had a peptic ulcer
  • you have asthma or any other respiratory disease
  • you have heart disease
  • you have liver or kidney disease
  • you have epilepsy
  • you are taking any other medication

Pregnancy: avoid. It is unknown how this medication may affect your baby. Consult your doctor before using this drug, or if you are planning to fall pregnant.

Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.

Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.

Infants and children: This medication is not intended for use in children.

The elderly: no special precautions need to be taken.

Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or extreme fatigue. Avoid such activities until you know how this medication affects you.

Alcohol: Avoid concomitant use of alcohol with this medication as the effect of rivastigmine may be reduced.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

loss of appetite

x

x

weight loss

x

x

dizziness

x

x

nausea/vomiting

x

x

diarrhoea

x

x

abdominal pain

x

x

drowsiness

x

x

agitation

x

x

confusion

x

x

sweating

x

x

chest pain

x

x

convulsions

x

x

Interactions

Drug interactions

tacrine

risk of rivastigmine toxicity

suxamethonium

potentiated muscle relaxation during anaesthesia

Disease interactions

Consult your doctor before using this drug if you have or had a peptic ulcer, epilepsy, asthma or any other respiratory disease, or if you have heart disease.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage

Adults: 1.5-6mg twice daily

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 

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