Rivastigmine
1 medicine
Rivastigmine is a cholinesterase inhibitor used for dementia in Alzheimer's and Parkinson's disease. It can slow the heart rate and cause gastrointestinal effects, and old transdermal patches must be removed before a new one is applied to avoid overdose.
Key facts
- Rivastigmine (Exelon) is a cholinesterase inhibitor that raises levels of acetylcholine, a brain chemical involved in memory and thinking.
- It comes as capsules, an oral solution, and a transdermal patch changed once daily; the patch delivers a steadier dose with less stomach upset.
- Rivastigmine can slow the heart rate (bradycardia) and cause fainting, especially in people with existing heart rhythm problems.
- With the patch, always remove the old one before applying a new one. Wearing more than one patch at a time is a recognized cause of overdose.
What Rivastigmine treats
Rivastigmine treats mild to moderate dementia caused by Alzheimer's disease, and dementia associated with Parkinson's disease. It can improve memory, attention, and daily function in some people, but it does not treat the tremor or movement symptoms of Parkinson's disease, and it does not reverse or cure dementia.
How Rivastigmine works
Rivastigmine blocks the enzymes that break down acetylcholine, a chemical messenger nerve cells use to communicate. With less breakdown, more acetylcholine is available in the brain, which can improve memory and thinking in dementia, though the underlying loss of nerve cells continues.
Before you take it
- Tell your prescriber about heart rhythm problems (including a slow heart rate), fainting spells, active stomach ulcers, asthma or severe lung disease, or seizures, since rivastigmine can worsen these.
- Do not take it if you have had an allergic reaction to rivastigmine or related carbamate medicines.
- Anaesthesia and some muscle relaxants used in surgery can interact with rivastigmine; tell your surgical team you are taking it.
- Nausea and vomiting are more likely when starting or increasing the dose; doses are usually raised slowly to reduce this.
Side effects
Common effects include nausea, vomiting, loss of appetite, and dizziness, plus skin irritation at a patch site.
Seek urgent care for:
- A slow, fast, or irregular heartbeat, or fainting.
- Severe or persistent vomiting, especially with signs of dehydration.
- Signs of overdose from wearing more than one patch: severe nausea, vomiting, muscle weakness, or a slow heartbeat.
Safety essentials
- Rivastigmine can cause bradycardia (a slow heart rate) and significant gastrointestinal effects; regular review of heart rate and symptoms is part of safe use, especially early in treatment or after a dose increase.
- With the patch, remove the previous one before applying a new one and rotate application sites. Leaving old patches on is a documented cause of overdose.
- Report new fainting, a very slow pulse, or severe vomiting to a doctor promptly.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.