Medication Guide App

Exelon Side Effects

Generic Name: rivastigmine

Note: This page contains information about the side effects of rivastigmine. Some of the dosage forms included on this document may not apply to the brand name Exelon.

Not all side effects for Exelon may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to rivastigmine: oral capsule, oral solution

In addition to its needed effects, some unwanted effects may be caused by rivastigmine (the active ingredient contained in Exelon). In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking rivastigmine:

More common
  • Diarrhea
  • indigestion
  • loss of appetite
  • loss of strength
  • nausea and vomiting
  • weight loss
Less common
  • Fainting
  • Aggression
  • convulsions (seizures)
  • trembling and shaking of the hands and fingers
  • trouble urinating
Incidence not known
  • Bloody or black, tarry stools
  • chest pain or discomfort
  • constipation
  • difficulty with speaking
  • drooling
  • lightheadedness, dizziness, or fainting
  • loss of balance control
  • muscle trembling, jerking, or stiffness
  • restlessness
  • severe stomach pain
  • shortness of breath
  • shuffling walk
  • slow or irregular heartbeat
  • stiffness of the limbs
  • trouble urinating
  • twisting movements of the body
  • uncontrolled movements, especially of the face, neck, and back
  • unusual tiredness
  • vomiting of blood or material that looks like coffee grounds

If any of the following symptoms of overdose occur while taking rivastigmine, get emergency help immediately:

Symptoms of overdose
  • Chest pain or discomfort
  • increased sweating
  • increased watering of the mouth
  • irregular, fast, slow, or shallow breathing
  • lightheadedness, dizziness, or fainting
  • nausea (severe)
  • pale or blue lips, fingernails, or skin
  • seizures
  • slow or irregular heartbeat
  • trouble breathing
  • unusual tiredness
  • vomiting (severe)

Some of the side effects that can occur with rivastigmine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Abdominal or stomach pain or cramping
  • bloated or full feeling
  • confusion
  • dizziness
  • headache
  • mental depression
  • seeing, hearing, or feeling things that are not there
  • trouble sleeping
Less common
  • General feeling of discomfort or illness
  • runny nose

For Healthcare Professionals

Applies to rivastigmine: oral capsule, oral solution, transdermal film extended release


When treatment is interrupted for longer than several days, treatment must be reinitiated with the lowest daily dose to reduce the possibility of severe vomiting and its potentially serious sequelae.[Ref]

Gastrointestinal effects including nausea (47%), vomiting (31%), diarrhea (19%), anorexia (17%), abdominal pain (13%), dyspepsia (9%), constipation (5%), flatulence (4%), and eructation (2%) have been reported. There has also been one postmarketing report of severe vomiting with esophageal rupture following inappropriate reinitiation of treatment. Postmarketing reports have included duodenal ulcers.[Ref]

Nervous system

Nervous system side effects including dizziness (21%), headache (17%), somnolence (5%), tremor (4%), increased sweating (4%), and syncope (3%) have been reported. Postmarketing reports have included confusion.[Ref]


General side effects including accidental trauma (10%), fatigue (9%), asthenia (6%), malaise (5%), influenza-like symptoms (3%), and decreased weight (3%) have been reported.[Ref]


Psychiatric side effects including insomnia (9%), confusion (8%), depression (6%), anxiety (5%), hallucination (4%), and aggressive reaction (3%) have been reported.[Ref]


Dermatologic side effects including Stevens-Johnson syndrome have been reported. A case of erythematous macropapular eruption due to rivastigmine (the active ingredient contained in Exelon) therapy has also been reported. Postmarketing side effects have included reports of disseminated cutaneous hypersensitivity reactions.[Ref]


Genitourinary side effects including urinary tract infection (7%) have been reported.[Ref]


Respiratory side effects including rhinitis (4%) have been reported.[Ref]


Cardiovascular side effects including hypertension (3%) have been reported. A case of complete atrioventricular block has also been reported.[Ref]


Hepatic side effects have included abnormal liver function tests.


1. "Product Information. Exelon (rivastigmine)" Novartis Pharmaceuticals, East Hanover, NJ.

2. Monastero R, Lopez G, Mannino M, Camarda R "Erythematous maculopapular eruption due to rivastigmine therapy." Am J Med 111 (2001): 583-4

3. Kayrak M, Yazici M, Ayhan SS, Koc F, Ulgen MS "Complete atrioventricular block associated with rivastigmine therapy." Am J Health Syst Pharm 65 (2008): 1051-3

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.