GENERIC NAME: rivastigmine
BRAND NAME: Exelon, Exelon Patch
DRUG CLASS AND MECHANISM: Rivastigmine is an oral medication used to treat patients with Alzheimer's disease. Rivastigmine is in a class of drugs called cholinesterase inhibitors that also includes tacrine (Cognex), donepezil (Aricept), and galantamine (Razadyne - formerly known as Reminyl). Cholinesterase inhibitors inhibit (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 six 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). Rivastigmine was approved by the FDA in 1998.
SIDE EFFECTS: The most common side effects are:
About one-half of patients who take rivastigmine develop nausea, and about one-third vomit at least once, most commonly during the first few weeks of treatment as the dose is slowly increased. Between one in five and one in four patients lose weight during rivastigmine therapy (about 7 to 10 pounds, on average). One in six patients experiences a loss of appetite. About one in fifty patients develops dizziness. Overall, 15% of patients (between one in seven and one in six) discontinue therapy due to side effects.
Quick GuideDementia Pictures Slideshow: Disorders of the Brain
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