Rivastigmine

Rivastigmine is a prescription medication used to treat dementia in people with Alzheimer's disease or Parkinson's disease. Rivastigmine belongs to a group of drugs called acetylcholinesterase inhibitors. It works by increasing the amount of certain natural subtances to improve mental function. 

Rivastigmine is a prescription medicine used to treat dementia in people with Alzheimer's disease or Parkinson's disease.

Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you.

• The recommended rivastigmine starting dose for Alzheimer's Dementia is 1.5 mg taken twice daily. The dose may be increased after a minimum of 2 weeks, to 3 mg twice daily, if rivastigmine is well tolerated and dose increase is necessary. After two more weeks, the dose may be further increased to 4.5 mg taken twice daily. Then, after an additional two weeks, the maximum recommended dose of 6 mg twice daily may be given.
• The recommended rivastigmine starting dose for Parkinson's Dementia is 1.5 mg taken twice daily. The dose may be increased after a minimum of 4 weeks, to 3 mg twice daily, if rivastigmine is well tolerated and dose increase is necessary. After four more weeks, the dose may be further increased to 4.5 mg taken twice daily. Then, after an additional four weeks, the maximum recommended dose is 6 mg twice daily may be given.

Rivastigmine Patch

• Rivastigmine patches come in 3 different dosage strengths.
• Your healthcare provider may change your dose as needed.
• Wear only 1 patch at a time.

Rivastigmine may cause serious side effects including:    

• stomach or bowel (intestinal) problems, including:
  • nausea  
  • vomiting 
  • diarrhea 
  • loss of appetite 
  • weight loss 
  • bleeding in your stomach (ulcers) 
• heart problems 
• seizures 
• problems with movement (tremors) 
• Skin reactions. Some people have had a serious skin reaction called allergic contact dermatitis (ACD) when using rivastigmine patch. Stop using rivastigmine patch and call your healthcare provider right away if you experience reactions that spread beyond the patch size, are intense in nature and do not improve within 48 hours after the patch is removed. Symptoms of ACD may be intense and include:
  • itching, redness, swelling, warmth or tenderness of the skin
  • peeling or blistering of the skin that may ooze, drain or crust over

Do not take rivastigmine if you are allergic to any of the ingredients rivastigmine. 

Rivastigmine may cause serious side effects. See "Drug Precautions" section.

• nausea
• vomiting
• loss of appetite
• dizziness

The most common side effects of rivastigmine patch include:

• depression
• headache
• anxiety
• dizziness
• stomach pain
• urinary tract infections
• muscle weakness
• tiredness
• trouble sleeping

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.  These are not all the possible side effects of rivastigmine.  For more information, ask your healthcare provider or pharmacist.

Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following:

• antihistamines
• aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
• bethanechol (Duvoid, Urabeth, Urecholine)
• ipratropium (Atrovent)
• medicines for Alzheimer's disease
• glaucoma medicines
• medicines for irritable bowel disease, motion sickness, myasthenia gravis, Parkinson's disease, ulcers, or urinary problems. 

Your doctor may need to change the doses of your medications or monitor you carefully for side effects. 

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Rivastigmine falls into category B. There are no well-done studies that have been done in humans with rivastigmine. But in animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

It is not known if rivastigmine crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using rivastigmine.

Rivastigmine may improve the ability to think and remember or slow the loss of these abilities, but does not cure Alzheimer's disease or dementia in people with Parkinson's disease. Continue to take rivastigmine even if you feel well.

Rivastigmine may cause nausea and vomiting associated along with the possibility of anorexia and weight loss. Tell your doctor if these side effects occur.

Only apply rivastigmine patch to healthy skin that is clean, dry, hairless, and free of redness, irritation, burns or cuts.

• Avoid applying rivastigmine patch to areas on your body that will be rubbed against tight clothing.
• Do not apply rivastigmine patch to skin that has cream, lotion, or powder on it.