Drug reference

Rivastigmine

Cholinesterase Inhibitor · Agent for Alzheimer's Disease

Cholinesterase InhibitorAgent for Alzheimer's Disease

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

6 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 6 →

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Mechanism

Rivastigmine is an acetylcholinesterase inhibitor. It increases the concentration of acetylcholine in the synaptic cleft by reversibly inhibiting the enzyme acetylcholinesterase, which is responsible for the hydrolysis of acetylcholine.

Indications

Mild-to-moderate Alzheimer’s diseaseMild-to-moderate dementia with Lewy bodies (off-label)Severe dementia with Lewy bodies (off-label)Vascular dementia with suspected co-morbid Alzheimer’s disease, Parkinson’s disease dementia, or dementia with Lewy bodies (off-label)Symptomatic treatment of mild-moderate AD dementiaMild-moderate PD dementiaOther neurodegenerative diseases with cholinergic deficitsalzheimer’s disease

Dosing

Adult: Dose should be started low and increased if tolerated and necessary.
Hepatic adjustment: Caution advised in mild to moderate impairment (risk of increased exposure). Dose escalation should be performed according to individual tolerability in mild to moderate impairment. No information available in severe impairment.

Pharmacokinetics

Bioavailability

72 (22–119)%

Protein binding

High lipid solubility

Metabolism

Esterases

Excretion

Negligible

Contraindications

Frontotemporal dementia
Cognitive impairment caused by multiple sclerosis

Side effects

Common

Aggressionagitationappetite decreasedcommon colddiarrhoeadizzinessfatiguegastrointestinal disordershallucinationheadacheinjurymuscle crampsnauseapainskin reactionssleep disorderssyncopeurinary incontinencevomitingGI distressmuscle crampingabnormal dreams

Serious