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Rivastigmine
Aka: Rivastigmine, Exelon
- See Also
- Acetylcholinesterase Inhibitor
- Dementia
- Dementia Management
- Donepezil (Aricept)
- Galantamine (Reminyl)
- Indications
- Alzheimer Disease
- Lewy Body Dementia
- Mechanism
- See Acetylcholinesterase Inhibitor
- Carbamate-based noncompetitive Cholinesterase Inhibitor
- Inhibits butyrylcholinesterase and acetylcholinesterase
- Increases Cholinergic transmission
- Pharmacokinetics: Oral Route
- Peak: 1 hour
- Duration: 10 hours
-
Drug Interactions
- No significant Drug Interactions
- Efficacy
- Modestly improves scores on Neuropsychological Tests
- Benefits decrease after 40 weeks of treatment
- Adverse Effects
- See Acetylcholinesterase Inhibitor
- Specific adverse effects reported for Rivastigmine, not seen with other Acetylcholinesterase Inhibitors
- Abdominal Pain
- Atrial Fibrillation
- Myocardial Infarction
- Dosing
- Oral Route
- Initial: 1.5 mg orally twice daily with food for at least 2 weeks (4 weeks for Lewy Body Dementia)
- Next: 3 mg orally twice daily with food for at least 2 weeks (4 weeks for Lewy Body Dementia)
- Next: 4.5 mg orally twice daily with food for at least 2 weeks (4 weeks for Lewy Body Dementia)
- Next: 6 mg orally twice daily with food
- Transdermal Patch
- Initial: 4.6 mg patch every 24 hours for at least 4 weeks
- Next: 9.5 mg patch every 24 hours for at least 4 weeks
- Next: 13.3 mg patch every 24 hours
- References
- (2000) Med Lett Drugs Ther 42(1089):93-4 [PubMed]
- Corey-Bloom (1998) Int J Geriatr Psychopharm 1:55 [PubMed]
- Epperly (2017) Am Fam Physician 95(12): 771-8 [PubMed]
- Rosler (1999) BMJ 318:633 [PubMed]