Rivastigmine

Pronunciation

Generic Name: rivastigmine (RIV-a-STIG-meen)
Brand Name: Exelon

Rivastigmine is used for:

Treating mild to moderate dementia (eg, impairment of memory or judgment, abstract thinking, changes in personality) in patients with Alzheimer or Parkinson disease.

Rivastigmine is a cholinesterase inhibitor. It works by increasing the amount of a certain substance (acetylcholine) in the brain, which may help reduce symptoms of dementia in patients with Alzheimer disease.

Do NOT use rivastigmine if:

  • you are allergic to any ingredient in rivastigmine or to carbamate derivatives (eg, meprobamate)
  • you have had a skin reaction to the patch form of rivastigmine in the past and you have not had a negative allergy test
  • you are taking another form of rivastigmine (eg, patch, solution) or another cholinesterase inhibitor (eg, donepezil)

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Flashback: FDA Drug Approvals 2013

Before using rivastigmine:

Some medical conditions may interact with rivastigmine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of kidney or liver problems, certain heart problems (eg, slow or irregular heartbeat, sick sinus syndrome), inflammation of the pancreas (pancreatitis), seizures (eg, epilepsy), stomach or bowel problems (eg, an ulcer), lung or breathing problems (eg, asthma, chronic obstructive pulmonary disease [COPD]), or a urinary blockage (trouble urinating)
  • if you have dementia or other decreased mental ability that is not caused by Alzheimer or Parkinson disease
  • if you are scheduled to have surgery or other medical procedures with general anesthesia
  • if you are dehydrated or if you weigh less than 110 pounds (50 kg)

Some MEDICINES MAY INTERACT with rivastigmine. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of stomach or bowel bleeding may be increased
  • Cholinergic agents (eg, bethanechol) or another cholinesterase inhibitor (eg, donepezil) because they may increase the risk of rivastigmine's side effects
  • Anticholinergics (eg, scopolamine) because their effectiveness may be decreased by rivastigmine

This may not be a complete list of all interactions that may occur. Ask your health care provider if rivastigmine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use rivastigmine:

Use rivastigmine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take rivastigmine by mouth with the morning and evening meals, unless your doctor tells you otherwise.
  • Take rivastigmine on a regular schedule to get the most benefit from it.
  • Taking rivastigmine at the same time each day will help you remember to take it.
  • Continue to take rivastigmine even if you feel well. Do not miss any doses.
  • If you miss a dose of rivastigmine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Contact your doctor if you miss several doses of rivastigmine. Your doctor may need to restart your medicine at a lower dose to avoid side effects.

Ask your health care provider any questions you may have about how to use rivastigmine.

Important safety information:

  • Rivastigmine may cause dizziness, drowsiness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use rivastigmine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do NOT take more than the recommended dose, change your dose, or stop taking rivastigmine without checking with your doctor.
  • When you begin taking rivastigmine, your doctor will increase your dose slowly over several months. This may help to decrease the risk of certain side effects (eg, nausea, vomiting, loss of appetite). Carefully follow the dosing schedule prescribed by your doctor.
  • If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions.
  • Tell your doctor or dentist that you take rivastigmine before you receive any medical or dental care, emergency care, or surgery.
  • Rivastigmine should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking rivastigmine while you are pregnant. It is not known if rivastigmine is found in breast milk. Do not breast-feed while taking rivastigmine.

Possible side effects of rivastigmine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; drowsiness; headache; increased sweating; loss of appetite; nausea; stomach upset or pain; tiredness; trouble sleeping; vomiting; weakness; weight loss.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; chest pain; confusion; decreased coordination; decreased, increased, or painful urination; fainting; fever; hallucinations; new or worsening mental or mood changes (eg, agitation, anxiety, depression); new or worsening tremor or uncontrolled muscle movements; new or worsening trouble walking; red, swollen, blistered, or peeling skin; seizures; severe or persistent diarrhea, nausea, stomach pain, or vomiting; severe or persistent dizziness, tiredness, or weakness; severe or persistent loss of appetite or weight loss; slow or irregular heartbeat; trouble speaking or swallowing; twitching of the face or tongue; vomit that looks like blood or coffee grounds.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of rivastigmine:

Store rivastigmine at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep rivastigmine out of the reach of children and away from pets.

General information:

  • If you have any questions about rivastigmine, please talk with your doctor, pharmacist, or other health care provider.
  • Rivastigmine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take rivastigmine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about rivastigmine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to rivastigmine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using rivastigmine.

Issue Date: November 5, 2014
Database Edition 14.4.1.002
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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