Alzheimer's dementia:
Indications for: Rivastigmine
Mild to moderate dementia of the Alzheimer's type.
Adult Dosage:
Take with food in the AM and PM. Initially 1.5mg twice daily; if well-tolerated, may increase by 1.5mg twice daily at intervals of at least 2 weeks. Usual range: 6–12mg/day; max 12mg/day. If dose is not tolerated, suspend for several doses and restart at same or next lower dose. If stopped for >3 days, restart at 1.5mg twice daily and retitrate. Moderate to severe renal or mild to moderate hepatic impairment: use lower doses. Low body wt. (<50kg): monitor for toxicities and consider reducing dose.
Children Dosage:
<18yrs: not recommended.
Rivastigmine Contraindications:
Patches: previous history of application site reactions suggestive of allergic contact dermatitis (in the absence of negative allergy testing).
Rivastigmine Warnings/Precautions:
Monitor for nausea, vomiting, anorexia, weight loss, GI bleed. Sick sinus syndrome, other supraventricular conduction disturbances. Seizures. History or risk of ulcers. Urinary obstruction. Asthma. COPD. Discontinue if disseminated allergic dermatitis occurs. Renal or hepatic impairment. Pregnancy. Nursing mothers.
See Also:
Rivastigmine Classification:
Reversible acetylcholinesterase inhibitor (carbamate deriv).
Rivastigmine Interactions:
Concomitant metoclopramide, beta-blockers, cholinomimetics, anticholinergics: not recommended. May potentiate succinylcholine-type muscle relaxants. Monitor for GI bleed with NSAIDs.
Adverse Reactions:
Nausea, vomiting, anorexia, dyspepsia, asthenia, diarrhea, abdominal pain, dizziness, weight loss, tremor, cholinergic effects; also, patches: application site reactions, allergic contact dermatitis (discontinue if suspected or no improvements within 48hrs after removal; or consider switching to oral form only after negative allergy testing; monitor).
How Supplied:
Caps—contact supplier; Patches—30
Parkinsonism:
Indications for: Rivastigmine
Mild to moderate dementia associated with Parkinson's disease.
Adult Dosage:
Take with food in the AM and PM. Initially 1.5mg twice daily; if tolerated, may increase by 1.5mg twice daily at intervals of at least 4 weeks. Usual range: 3–12mg/day; max 12mg/day. If dose is not tolerated, suspend for several doses and restart at same or next lower dose. If stopped for >3 days restart at 1.5mg twice daily and retitrate. Moderate to severe renal or mild to moderate hepatic impairment: use lower doses. Low body wt. (<50kg): monitor for toxicities and consider reducing dose. Patch: Apply to clean, dry, hairless intact skin. Rotate application site (allow 14 days before reapplying to same site). Initially apply one 4.6mg/24hrs patch once daily; if tolerated, may increase to 9.5mg/24hrs patch after 4 weeks at previous dose; can further be increased to max 13.3mg/24hrs dose. If dosing interrupted for >3 days, restart with 4.6mg/24hrs patch and retitrate. Mild to moderate hepatic impairment: initial and max dose 4.6mg/24hrs patch. Low body wt. (<50kg): monitor for toxicities and consider reducing maintenance dose to 4.6mg/24hrs patch. Switching from capsules: see full labeling.
Children Dosage:
<18yrs: not recommended.
Rivastigmine Contraindications:
Patches: previous history of application site reactions suggestive of allergic contact dermatitis (in the absence of negative allergy testing).
Rivastigmine Warnings/Precautions:
Monitor for nausea, vomiting, anorexia, weight loss, GI bleed. Sick sinus syndrome, other supraventricular conduction disturbances. Seizures. History or risk of ulcers. Urinary obstruction. Asthma. COPD. Discontinue if disseminated allergic dermatitis occurs. Renal or hepatic impairment. Pregnancy. Nursing mothers.
See Also:
Rivastigmine Classification:
Reversible acetylcholinesterase inhibitor (carbamate deriv).
Rivastigmine Interactions:
Concomitant metoclopramide, beta-blockers, cholinomimetics, anticholinergics: not recommended. May potentiate succinylcholine-type muscle relaxants. Monitor for GI bleed with NSAIDs.
Adverse Reactions:
Nausea, vomiting, anorexia, dyspepsia, asthenia, diarrhea, abdominal pain, dizziness, weight loss, tremor, cholinergic effects; also, patches: application site reactions, allergic contact dermatitis (discontinue if suspected or no improvements within 48hrs after removal; or consider switching to oral form only after negative allergy testing; monitor).
How Supplied:
Caps—contact supplier; Patches—30
