Rivastigmine (sold under the trade name Exelon) is a parasympathomimetic or cholinergic agent for the treatment of mild to moderate dementia of the Alzheimer’s type and dementia due to Parkinson’s disease.
The reference site for Rivastigmine
WHAT IS Rivastigmine?
Rivastigmine improves the function of nerve cells in the brain, and works by preventing the breakdown of a chemical called acetylcholine. People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.
Rivastigmine is approved for mild to moderate dementia of the Alzheimer’s type and for mild to moderate dementia related to Parkinson’s disease.
It is sold in the US under that trade name Exelon® but is also known as Prometax® in the UK. It was previously known as SDZ ENA 713.
Brand Name(s): Exelon
CAS nº: 123441-03-2
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The sections below will provide you with more specific information and guidelines related to rivastigmine and its correct use. Please read them carefully.
Rivastigmine was first developed by Novartis for the treatment of mild to moderate dementia of the Alzheimer’s type, and launched in the the European Union in 1998 and in the US in 2000.
In 2006, it became the first product approved by the US FDA for the treatment of mild to moderate dementia associated with Parkinson’s Disease. A prescription is required for this medicine.
Why is this medication prescribed?
Rivastigmine is used to treat mild to moderate dementia caused by Alzheimer’s or Parkinson’s disease.
Drug class and mechanism:
Rivastigmine is in a class of drugs called cholinesterase inhibitors that also includes tacrine (Cognex®), donezepil (Aricept®), and galantamine (Reminyl®).
Cholinesterase inhibitors block the action of acetylcholinesterase, the enzyme responsible for the destruction of acetylcholine. Acetylcholine is one of several neurotransmitters in the brain, chemicals that nerve cells use to communicate with one another. Reduced levels of acetylcholine in the brain are believed to be responsible for some of the symptoms of Alzheimer’s disease. By blocking the enzyme that destroys acetylcholine, rivastigmine increases the concentration of acetylcholine in the brain, and this increase is believed to be responsible for the improvement in thinking seen with rivastigmine.
For most patients who take rivastigmine there will not be a dramatic improvement, but the progression of symptoms may be slowed. After 6 months of treatment with rivastigmine, 25-30% of patients scored better on tests of memory, understanding, and activities of daily living as compared with only 10-20% of patients receiving placebo (a dummy or sugar pill).
Other uses for this medicine
Rivastigmine also is used sometimes to treat Lewy body dementia.
However, it is important that you talk to your doctor about the possible risks of using this drug for your particular condition.
Dosage and using this medicine
Rivastigmine (Exelon®) is available as a capsule or as a liquid.
This medication is usually taken twice a day, in the morning and evening. However, take rivastigmine exactly as it was prescribed for you and do not take the medication in larger amounts, or take it for longer than recommended by your doctor.
Your doctor may occasionally change your dose to make sure you get the best results from this medication.
Additionally, this medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
If you need to have any type of surgery, tell the surgeon ahead of time that you are taking rivastigmine. You may need to stop using the medicine for a short time.
Take the rivastigmine capsules with a full glass of water, and also with food.
Do not use a regular table spoon to measure a dose of rivastigmine oral liquid (solution). Use the syringe provided.
You may swallow the oral liquid directly from the syringe or mix the medicine with a small glass of water, fruit juice, or soda. Do not use any other liquids to mix with rivastigmine oral liquid.
Stir the medicine mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.
After using the syringe, wipe the outside of it with a clean tissue and put the syringe back into its case. Close the medicine bottle using the child resistant closure.
It is important to use rivastigmine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
If you stop taking rivastigmine for any reason, do not restart the medication without first talking with your doctor. You may need to restart treatment with a lower dose.
What special precautions should I follow?
BEFORE TAKING RIVASTIGMINE:
Tell your doctor if you have a heart rhythm disorder such as “sick sinus syndrome” (slow heartbeats), an enlarged prostate or urination problems, epilepsy or other seizure disorder, or asthma or obstructive pulmonary disease. You may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
Moreover, please inform your doctor if you are using any of the following drugs: atropine (Donnatal®, and others); belladonna; clidinium (Quarzan®); dicyclomine (Bentyl®); glycopyrrolate (Robinul®); hyoscyamine (Anaspaz®, Cystospaz®, Levsin®, and others); mepenzolate (Cantil®); methantheline (Provocholine®); methscopolamine (Pamine®); propantheline (Pro-Banthine®); or scopolamine (Transderm-Scop®). If you are using any of these drugs, you may not be able to use rivastigmine or you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect rivastigmine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without first telling your doctor.
This medication falls into the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
Furthermore, it is not known whether rivastigmine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Rivastigmine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
What should I do if I forget a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Please do not take extra medicine to make up the missed dose.
If you miss several doses in a row, call your doctor before taking any more of this medication.
What side effects can this medication cause?
Get emergency medical help if you have any of these signs of an allergic reaction:
swelling of your face, lips, tongue, or throat
Stop using rivastigmine and call your doctor at once if you have any of these serious side effects:
nausea and vomiting
loss of appetite
black, bloody, or tarry stools
coughing up blood or vomit that looks like blood or coffee grounds
feeling light-headed, fainting
confusion, agitation, extreme fear
pain or burning when you urinate
Continue taking rivastigmine and talk with your doctor if you have any of these less serious side effects:
upset stomach or diarrhea
weakness or dizziness
swelling in your hands or feet
cough, runny or stuffy nose
sleep problems (insomnia)
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What storage conditions are needed for this medicine?
Try to keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture in an upright position.
Please remember to throw away any medication that is outdated or no longer needed and, if necessary, talk to your pharmacist about the proper disposal of your medication.
In case of an emergency/overdose
In the case of a suspected overdose, call your local poison control center on 1-800-222-1222. However, if the victim has collapsed or is not breathing, please call the local emergency services immediately on 911.
Symptoms of overdose may include:
PICTURES OF RIVASTIGMINE PRODUCTS
Below you will find images and specific information regarding the principal types of rivastigmine that exist, including their respective brand name(s), strength, inscription codes, manufacturers and/or distributors.
The information below includes general information and guidelines for patients taking this medication and should never be used to substitute professional medical advice that can be provided by a qualified physician or family doctor.
Strength(s): 3 MG
Imprint: EXELON 3 mg
Strength(s): 4.5 MG
Imprint: EXELON 4.5 mg
Strength(s): 6 MG
Imprint: EXELON 6 mg