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Rivastigmine is a drug to treat dementia due to Alzheimer's or Parkinson's disease. This medication is available in the form of a transdermal patch .

Rivastigmine works by inhibiting the breakdown of a special chemical compound in the brain, namely acetylcholine which plays a role in the process of remembering or thinking. These chemical compounds levels are quite low in people with dementia .

Rivastigmine trademarks: Exelon Patch 5, Exelon Patch 10

What is Rivastigmine

class Prescription drug
Category Cholinesterase inhibitors
Benefit Treating dementia due to Alzheimer's or Parkinson's disease
Used by Mature
Rivastigmine for pregnant and lactating women


Category B: Animal studies have not demonstrated a risk to the fetus, but there are no controlled studies in pregnant women.

It is not known whether Rivastigmine is absorbed into breast milk or not. If you are breastfeeding, do not use this medicine without consulting your doctor first.

Drug form Transdermal patches

Precautions Before Using Rivastigmine

Rivastigmine should only be used as prescribed by a doctor. Note the following points before using rivastigmine:

  • Tell your doctor about any history of allergies you have. Rivastigmine should not be given to patients who are allergic to this drug, neostigmine, physostigmine, or pyridostigmine.
  • Tell your doctor if you have had or currently have seizures , heart disease, liver disease, kidney disease, bleeding in the digestive tract , asthma, or chronic obstructive pulmonary disease ( COPD ).
  • Tell your doctor if you are taking certain medications, supplements or herbal products.
  • Tell your doctor that you are taking rivastigmine before having any laboratory tests or certain medical procedures.
  • Do not drive a vehicle or do activities that require alertness after taking rivastigmine, because this drug can cause dizziness or drowsiness.
  • Protect the patch from direct exposure to heat, because it can increase absorption and the risk of drug side effects.
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy.
  • See your doctor immediately if you have an allergic drug reaction , serious side effects, or overdose after using rivastigmine.

Dosage and Rules for Use Rivastigmine

The dose of rivastigmine given by doctors can vary for each patient depending on the patient's health condition and body response.

In general, the dose of rivastigmine for dementia caused by Alzheimer's or Parkinson 's disease is 4.6 mg, every 24 hours. Dosage may be increased up to 9.6 mg every 24 hours after 4 weeks. The maximum dose is 13.3 mg, every 24 hours.

How to Use Rivastigmine Properly

Use rivastigmine as directed by your doctor and the instructions on the drug packaging. Do not use more than one patch at a time.

Rivastigmine should not be used on broken or irritated skin. Use the patch on flat, dry areas of skin, such as the chest, back, or upper arms for better adherence. If necessary, clip the hair in the skin area where the drug will be attached.

Paste and press the transdermal patch for 30 seconds, so that the drug sticks properly. Release the drug after 24 hours or according to doctor's advice. Be sure to remove the old patch first, then stick the new patch in a different area. Do not use the same skin area within 14 days.

If you forget to use rivastigmine, apply the patch as soon as you remember. Do not use an extra patch to make up for a forgotten dose.

Store the rivastigmine patch in a closed container to avoid exposure to direct sunlight, store at room temperature. Keep this drug out of reach of children.

Rivastigmine Interactions with Other Drugs

The following are some of the interaction effects that can occur when rivastigmine is used with certain drugs:

  • Increased risk of seizures when used with metrizamide, iohexol, tramadol or bupropion
  • Increased risk of developing bradycardia (slow heart rate) when used with beta-blocking drugs , such as atenolol
  • Decreased effect of rivastigmine when used with oxybutynin or tolterodine
  • Increased risk of torsade de pointes (TdP) when used with chlorpromazine, sulpiride , pimozide, or cisapride

Rivastigmine Side Effects and Dangers

Tell your doctor if the side effects below do not go away or get worse:

  • Nausea or vomiting
  • Irritation of the skin area where it is applied
  • Loss of appetite or weight loss
  • Tremors
  • Weakness, dizziness, drowsiness

Check with your doctor if the complaints mentioned above do not go away or get worse. Immediately see a doctor if you experience an allergic drug reaction or experience more serious side effects, such as:

  • Slow or irregular heart rate
  • Black stools or vomit like the color of coffee
  • Severe stomach ache
  • It's hard to breathe
  • Difficulty urinating
  • seizures
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