Skip to main content

Rivastigmine Side Effects

Medically reviewed by Last updated on Sep 23, 2022.


Commonly reported side effects of rivastigmine include: abdominal pain, diarrhea, dizziness, headache, nausea, vomiting, weight loss, and anorexia. Other side effects include: anxiety, asthenia, depression, drowsiness, dyspepsia, fatigue, tremor, diaphoresis, flatulence, and malaise. Continue reading for a comprehensive list of adverse effects.

Applies to rivastigmine: transdermal patch extended release.

Serious side effects of Rivastigmine

Along with its needed effects, rivastigmine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking rivastigmine:

More common

  • Bladder pain
  • bloody or cloudy urine
  • difficult, burning, or painful urination
  • frequent urge to urinate
  • lower back or side pain

Less common


  • Abdominal or stomach pain or tenderness
  • arm, back, or jaw pain
  • chest pain, tightness, heaviness, or discomfort
  • confusion
  • convulsions
  • decreased urine
  • difficult or troubled breathing
  • dilated neck veins
  • extreme fatigue
  • false beliefs that cannot be changed by facts
  • irregular breathing
  • irregular heartbeat
  • loss of consciousness
  • rapid breathing
  • seizures
  • severe nausea or vomiting
  • shortness of breath
  • sunken eyes
  • swelling of the face, fingers, feet, or lower legs
  • wrinkled skin

Incidence not known

  • Blistering, burning, crusting, dryness, or flaking of the skin
  • burning, itching, redness, skin rash, swelling, or soreness at the application site
  • fast, pounding, or irregular heartbeat or pulse
  • hives or welts
  • itching
  • itching, scaling, severe redness, soreness, or swelling of the skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking rivastigmine:

Symptoms of overdose

  • Blurred vision
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • increasing muscle weakness
  • irregular, fast or slow, or shallow breathing
  • pale or blue lips, fingernails, or skin
  • slow or irregular heartbeat
  • sweating
  • unusual tiredness or weakness
  • watering of mouth

Other side effects of Rivastigmine

Some side effects of rivastigmine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Diarrhea
  • discouragement
  • fear
  • feeling of constant movement of self or surroundings
  • feeling sad or empty
  • irritability
  • lack of appetite
  • lack or loss of strength
  • loss of interest or pleasure
  • nausea
  • redness at the application site
  • sensation of spinning
  • stomach pain
  • tiredness
  • trouble concentrating
  • trouble sleeping
  • upper stomach pain
  • vomiting
  • weight loss


  • Blindness
  • burning, stinging, or pain at application site
  • continuing ringing or buzzing or other unexplained noise in the ears
  • decreased vision
  • difficulty with moving
  • eye pain
  • hearing loss
  • itchy skin
  • muscle pain or stiffness
  • pain in the joints
  • pale skin
  • tearing
  • troubled breathing with exertion
  • unusual bleeding or bruising

For Healthcare Professionals

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


Common (1% to 10%): Hyperhidrosis

Rare (less than 0.1%): Rash

Frequency not reported: Pruritus

Postmarketing reports: Stevens-Johnson syndrome disseminated allergic dermatitis[Ref]


Common (1% to 10%): Hypertension, bradycardia

Uncommon (0.1% to 1%): Hypotension

Rare (0.01% to 0.1%): Angina pectoris

Very rare (less than 0.01%): Cardiac arrhythmia (e.g., bradycardia, atrioventricular block, atrial fibrillation, tachycardia)

Frequency not reported: Sick sinus syndrome[Ref]


Very common (10% or more): Nausea (47%), vomiting (31%)diarrhea (19%), abdominal pain (13%)

Common (1% to 10%): Dyspepsia, salivary hypersecretion, upper abdominal pain, flatulence, eructation

Rare (0.01% to 0.1%): Gastric and duodenal ulcers

Very rare (less than 0.01%): GI hemorrhage, pancreatitis

Frequency not reported: Some cases of severe vomiting were associated with esophageal rupture[Ref]


Common (1% to 10%): Urinary incontinence

Very rare (less than 0.01%): Urinary tract infection[Ref]


Frequency not reported: Elevated liver function tests, hepatitis[Ref]

Nervous system

Very common (10% or more): Tremor (23%), dizziness (21%)

Common (1% to 10%): Somnolence, bradykinesia, dyskinesia, cogwheel rigidity, hypokinesia, vertigo, psychomotor hyperactivity, gait disturbance, Parkinson gait, headache

Uncommon (0.1% to 1%): Syncope, dystonia

Rare (0.01% to 0.1%): Seizures[Ref]


Common (1% to 10%): Insomnia, confusion, depression, anxiety, hallucination, agitation, restlessness, nightmares[Ref]


Common (1% to 10%): Application site erythema, application site irritation (e.g., pruritus, rash)

Postmarketing reports: Application site hypersensitivity, urticaria, blister, allergic dermatitis[Ref]


Very common (10% or more): Anorexia (17%)

Common (1% to 10%): Decreased appetite

Frequency not reported: Dehydration[Ref]


Common (1% to 10%): Asthenia, weight loss, fatigue, malaise, fall[Ref]


Common (1% to 10%): Rhinitis[Ref]


1. "Product Information. Exelon (rivastigmine)." Novartis Pharmaceuticals (2001):

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

3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

4. 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

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.