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Rivastigmine Side Effects

In Summary

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

For the Consumer

Applies to rivastigmine: oral capsule, oral solution

As well as its needed effects, rivastigmine may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking rivastigmine, check with your doctor immediately:

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)

Minor Side Effects

Some rivastigmine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

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


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

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

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

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

It is possible that some side effects of rivastigmine may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

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.