Rivastigmine

  • Rivastigmine helps ease the symptoms of memory loss and dementia.
  • You will be given a small dose when you first start treatment. This will then be gradually increased.
  • If you are taking the capsules or oral solution, take your doses with or soon after a meal.
  • If you are using the patches, make sure you remove the old patch before applying a new one.
Type of medicine Acetylcholinesterase inhibitor
Used for Dementia associated with Alzheimer's disease or Parkinson's disease
Also called Exelon®
Available as Capsules, oral solution, and skin patches

Rivastigmine is used to treat the symptoms of mild-to-moderate dementia associated with Alzheimer's disease or in Parkinson's disease.

Rivastigmine cannot cure dementia but it can slow down the progression of dementia and can help to ease symptoms such as memory loss. It works by increasing the amount of a natural chemical in the brain, which is known to be lower in people suffering from dementia.

Before taking rivastigmine make sure your doctor or pharmacist knows:

  • If you have heart problems.
  • If you have asthma or chronic obstructive pulmonary disease (COPD).
  • If you have ever had problems with stomach or duodenal ulcers.
  • If you have ever had seizures (fits).
  • If you have liver or kidney problems.
  • If you have problems passing urine.
  • If you are pregnant, trying for a baby or breast-feeding.
  • If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
  • If you have ever had an allergic reaction to this or to any other medicine.
  • Before beginning treatment, read the manufacturer's printed information leaflet.
  • Take rivastigmine exactly as directed by your doctor. If you have been given the capsules or oral solution, take your doses with a meal or soon afterwards.
  • Try to take rivastigmine at the same times each day to avoid missing any doses. Ideally it should be taken with, or soon after, your breakfast and your evening meal.
  • The capsules must be swallowed whole without chewing or crushing. Taking your doses with a small drink of water will help.
  • If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a missed dose.
  • If you miss taking rivastigmine for several days, talk to your doctor before starting to take it again as you may need to re-start your treatment on a lower dose.

How to use the oral solution:

  • Open the bottle and remove the oral dosing syringe from its case.
  • Insert the nozzle of the syringe into the stopper on the top of the opened bottle.
  • Pull up the plunger on the syringe to withdraw the amount of solution required (removing any large air bubbles by moving the plunger up and down a few times).
  • Drink the solution directly from the syringe or stir it into a small amount of water before drinking.

How to apply the patches:

  • Open a packet and remove a patch.
  • Apply one patch to an area of clean, dry, non-hairy skin on the back, upper arm, or chest.
  • After 24 hours remove this patch and apply another patch to a different area of clean, dry, non-hairy skin on the back, upper arm, or chest. Avoid using the same area of skin for at least 14 days.
  • Repeat this process each day, removing one patch before applying the next.
  • When starting your treatment your doctor will give you a small dose and then gradually increase the dose. This allows your doctor to make sure that you have the dose that helps your condition and avoids any unwanted symptoms.
  • Your doctor will want to check your progress every few weeks to make sure the dose is right for you and that you are getting benefit from this treatment. Try to keep these regular doctor's appointments.
  • If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment that you are taking rivastigmine.
  • If you buy any medicines, always check with a pharmacist that they are safe to take with your other medicines.

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common side-effects - these affect less than 1 in 10 people who take this medicine What can I do if I experience this
Feeling or being sick, indigestion, abdominal pain Eat little and often. Stick to simple foods
Diarrhoea Drink plenty of water to replace any lost fluids
Dizziness, drowsiness, feeling tired Make sure your reactions are normal before doing anything that could be dangerous if you were not fully alert
Headache Ask your pharmacist to recommend a suitable painkiller. If the headache continues, tell your doctor
Sweating Take care not to become overheated during exercise or hot weather
Loss of appetite, weight loss, shakiness, agitation, confusion, and skin reactions (with patches only) If troublesome, speak with your doctor

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • Never take more than the prescribed dose. If you suspect that you or someone else has taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
  • This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
  • Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.

Further reading & references

Original Author: Helen Allen Current Version:
Last Checked: 20/08/2010 Document ID: 3317  Version: 22 © EMIS

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

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