rivastigmine, Exelon

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Quick Guide to Dementia



PREPARATIONS: Capsules: 1.5, 3, 4.5, and 6 mg. Solution: 2 mg/ml. Patch: 4.6mg/24 hours, 9.5 mg/24 hours

STORAGE: Capsules and solution should be stored at room temperature, 15 C - 30 C (59 F - 86 F).

PRESCRIBED FOR: Rivastigmine is used for the treatment of mild to moderate dementia of the Alzheimer's type or mild to moderate dementia associated with Parkinson's disease.

DOSING: Rivastigmine usually is taken twice daily with meals. Due to gastrointestinal side effects that can be seen early in therapy, rivastigmine therapy is generally started at a low dose.

For treating dementia associated with Alzheimer's the starting dose is 1.5 mg twice daily. It is gradually increased no more than once every two weeks. The goal usually is 3 to 6 mg twice daily. If a patient develops severe gastrointestinal side effects such as upset stomach and vomiting, he or she may need to stop taking rivastigmine for a few doses and then start taking it again at the same dose or a lower dose.

The starting dose for treating dementia associated with Parkinson's disease is 1.5 mg orally twice daily. The dose may be increased every four weeks to 3 to 6 mg twice daily. When using the patch the recommended starting dose is 4.6 mg/24 hours patch once daily. The patch should be replaced with a new one every day. The maximum dose is one 9.5 mg/24 hour patch. At least four weeks should elapse before increasing the dose.

DRUG INTERACTIONS: Drugs with anticholinergic effects and which cross into the brain, such as atropine, benztropine (Cogentin), and trihexylphenidyl (Artane) oppose the effects of rivastigmine and should be avoided during therapy with rivastigmine. Unlike donepezil (Aricept), rivastigmine does not cause the blood levels of other medications to rise and increase their risk for side effects.

Medically Reviewed by a Doctor on 5/18/2015

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