What is Rivastigmine?

Rivastigmine is primarily prescribed to treat dementia in patients with conditions such as Alzheimer’s and Parkinson’s disease. The drug works to improve thinking and memory in individuals with these illnesses by increasing the amount of a naturally-occurring chemical in the brain. It is sold under the product name Exelon®.

The drug is in a class called cholinesterase inhibitors. It is meant to ease the symptoms of dementia by boosting the amount of a chemical in the brain called acetylcholine. Treatment is usually begun with a small dosage, which is then increased depending on the patient’s reaction to the drug. The process of increasing the dosage of the drug can happen over the course of many weeks.

Rivastigmine comes in liquid, transdermal patch, and capsule forms. The pill and liquid are typically prescribed to be taken two times a day with a meal, usually in the morning and evening. The liquid comes with a special dosing syringe from which the drug can be taken directly. It can also be mixed in liquids such as water or juice. The patch is the first dementia drug available in that form, and is primarily beneficial due to a lower risk of side effects.

Some previous conditions may make taking rivastigmine too risky, or at least require that the patient be carefully observed by a doctor while taking the drug. These conditions include an abnormal heartbeat, ulcers, enlarged prostate, or asthma. The drug may also be problematic for patients who have had lung or heart disease. Women who are nursing, pregnant, or planning to become pregnant should disclose this information to the prescribing doctor.

The most commonly reported side effects of taking rivastigmine are mild and need only be reported to a doctor if they don’t go away or if they become more severe. They include nausea, low appetite, weight loss, and an upset stomach. Patients may also experience a headache, drowsiness, or dizziness. Tiredness, difficulty sleeping, and diarrhea are also common side effects of taking the drug.

More severe side effects of taking rivastigmine include anxiety, confusion, and a worsened mental state. There may also be physical difficulties such as decreased coordination and tremors, muscle movements, or walking difficulties that are either new or worsening. Some patients also have chest pain; painful urination; and black, tarry, or bloody stools. Any signs of an allergic reaction, including rash, breathing problems, a tight chest, and swelling in the areas above the neck should receive immediate medical attention.