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Rivastigmine

Alzest, Exelon, Prometax

Rivastigmine helps ease the symptoms of memory loss and dementia.

You will be given a small dose when you first start treatment. This will gradually be increased.

If you are taking the capsules or liquid medicine, take your doses after a meal.

If you are using the patches, make sure you remove the old patch before applying a new one.

At a glance

  • Rivastigmine is a medicine used to treat symptoms of dementia associated with Alzheimer's or Parkinson's disease.

  • It aims to slow the progression of symptoms, not cure the condition, by increasing a brain chemical.

  • A specialist doctor will prescribe rivastigmine, which comes as capsules, liquid, or skin patches.

  • Take capsules or liquid with meals, or apply a new patch daily to non-hairy skin.

  • Do not stop taking it suddenly; if you miss doses for several days, talk to your doctor.

  • Common side-effects include feeling sick, indigestion, diarrhoea, or dizziness.

  • Tell your doctor if you have liver, kidney, heart, or breathing problems before starting it.

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About rivastigmine

Tipo de medicamento

Anti-dementia medicine (an acetylcholinesterase inhibitor)

Usado para

Dementia associated with Alzheimer's disease or Parkinson's disease

También llamado

Almuriva®; Alzest®; Erastig®; Exelon®; Nimvastid®; Prometax®

Disponible como

Capsules, oral liquid medicine and skin patches

Rivastigmine is used to treat the symptoms of dementia, such as memory loss. It is prescribed for people who have dementia which is associated with Alzheimer's disease or enfermedad de Parkinson.

Rivastigmine cannot cure dementia, but it can slow down the progression of the symptoms in some people. It works by increasing the level of a natural chemical called acetylcholine. This is a chemical which allows nerve cells in the brain to communicate with each other, and it is known that people with dementia have low levels of it. The symptoms of dementia can be improved by increasing the levels of acetylcholine.

Rivastigmine will be prescribed by a specialist doctor. If you are a caregiver, please read this leaflet on behalf of the person who is receiving rivastigmine.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking rivastigmine it is important that your doctor or pharmacist knows:

  • Si tienes problemas de hígado o riñón.

  • Si tienes una afección cardíaca.

  • If you have any problems with your breathing, such as asthma or chronic obstructive pulmonary disease (COPD).

  • If you have any problems passing urine.

  • If you have ever had a stomach (gastric) or duodenal ulcer.

  • If you have ever had fits (convulsions or seizures).

  • Si está tomando o usando otros medicamentos. Esto incluye cualquier medicamento que esté tomando y que esté disponible para comprar sin receta, así como medicamentos herbales y complementarios.

  • Si alguna vez has tenido una reacción alérgica a un medicamento.

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  • Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about rivastigmine and a full list of side-effects which you may experience from it.

  • Your caregiver will help you take your medicine exactly as your doctor has told you. It is usual to be prescribed two doses to take each day. Your dose will be written on the label of your pack to remind you.

  • There are several different strengths of rivastigmine capsules and patches available, so make sure the product you have been given is the strength you were expecting. If you are unsure, ask your pharmacist for advice.

  • Ideally the capsules or liquid medicine should be taken with, or soon after, your breakfast and your evening meal. Try to take your doses at the same times each day as this will help you to remember to take them.

  • If you have been prescribed capsules to take, you should swallow the capsule whole without chewing or crushing it. Taking your doses with a small drink of water may help.

  • Si olvida tomar una dosis, tómela tan pronto como lo recuerde, a menos que esté cerca la hora de su próxima dosis, en cuyo caso omita la dosis olvidada. No tome dos dosis juntas para compensar una dosis olvidada.

  • If you forget to take rivastigmine for several days, talk with your doctor before starting to take it again, as you may need to re-start your treatment on a lower dose.

  • If you have been prescribed skin patches, you will be asked to apply one patch each day. Make sure the previous day's patch is removed before you apply a new patch. If the patches cause any irritation to your skin, you should let your doctor know about this.

Taking rivastigmine oral liquid medicine

  1. Read the manufacturer's instructions for the medicine you have been given.

  2. Open the bottle and remove the oral dosing syringe and bottle adaptor provided.

  3. Push the nozzle of the syringe into the bottle adaptor and insert it firmly into the top of the bottle.

  4. Turn the bottle upside down.

  5. Pull the plunger on the syringe a little way and push back up to get rid of any air bubbles. Then pull the plunger down to withdraw the required amount of medicine. Re-check your dose once you have removed the syringe from the bottle.

  6. You can swallow the medicine straight from the syringe, or you can stir it into a glass of water to drink it.

  7. When you have finished taking your dose, wipe the outside of the syringe with a tissue. The syringe can be cleaned in warm, soapy water.

Applying rivastigmine (Exelon®) patches

  1. Open a packet and remove the patch from inside.

  2. Apply the patch to an area of non-hairy skin on your back, upper arm, or chest (but not to your breast area). Press down on the patch with the palm of your hand for around 30 seconds. This will make sure it sticks firmly in place.

  3. After 24 hours, remove the patch and do not use the same area of skin to apply another patch to for at least 14 days.

  4. Repeat this process each day, removing the previous day's patch before applying a new patch.

  5. If you forget to apply a new patch for more than three days, talk with your doctor before applying another patch, as you may need a lower dose.

  • When starting your treatment your doctor will give you a small dose and then gradually increase the dose. This allows your doctor to make sure that you have the dose that helps your condition and avoids any unwanted side-effects.

  • Your doctor will want to check your progress every few weeks to make sure the dose is right for you and that you are getting benefit from this treatment. Try to keep these regular doctor's appointments.

  • If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking rivastigmine. This is because rivastigmine may affect the amount of any anaesthetic you may need.

  • If you buy any medicines, always check with a pharmacist that they are safe to take with your other medicines. Some medicines can interfere with the way rivastigmine works.

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Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. The table below lists some of the most common ones associated with rivastigmine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve over the first few days of taking a new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common rivastigmine side-effects

¿Qué puedo hacer si experimento esto?

Sentirse enfermo (náuseas) o estar enfermo (vómitos), indigestión, dolor de estómago (abdominal)

Let your doctor know if this happens, as your treatment may need reviewing

Diarrea

Drink plenty of water to replace any lost fluids. Let your doctor know if it continues

Sensación de mareo o cansancio

Be especially careful if you are using any tools or machines

Dolor de cabeza

Bebe mucha agua y pide a tu farmacéutico que te recomiende un analgésico adecuado. Si los dolores de cabeza continúan, consulta a tu médico

Loss of appetite, losing weight, feeling anxious or agitated, trembling, falling, sweating, and skin reactions (with the patches)

Si alguno de estos se vuelve problemático, hable con su médico

Si experimenta otros síntomas que cree que pueden deberse a este medicamento, hable con su médico o farmacéutico.

  • Mantenga todos los medicamentos fuera del alcance y la vista de los niños.

  • Almacenar en un lugar fresco y seco, lejos del calor y la luz directos.

  • Once opened, a bottle of the medicine only keeps for one month. Do not store it or use it after this time.

Información importante sobre todos los medicamentos

Nunca tome más de la dosis prescrita. Si sospecha que usted u otra persona podría haber tomado una sobredosis de este medicamento, acuda al departamento de accidentes y emergencias de su hospital local. Lleve el envase con usted, incluso si está vacío.

Este medicamento es para ti. Nunca lo des a otras personas, incluso si su condición parece ser la misma que la tuya.

No guardes medicamentos caducados o no deseados. Llévalos a tu farmacia local, que se encargará de desecharlos por ti.

Si tienes alguna pregunta sobre este medicamento, consulta a tu farmacéutico.

Informar efectos secundarios de un medicamento o vacuna

Si experimenta efectos secundarios, puede reportarlos en línea a través de Yellow Card website.

verificador de síntomas

¿Inseguro sobre mezclar medicamentos?

Verifica posibles interacciones entre medicamentos, suplementos y alimentos antes de tomarlos juntos.

Preguntas frecuentes

What is the main goal of rivastigmine treatment for dementia?

Rivastigmine is used to help manage the symptoms of dementia, such as memory loss, for people with Alzheimer's disease or Parkinson's disease. While it cannot cure dementia, it can help slow down the progression of these symptoms in some individuals.

How does rivastigmine work in the brain to help with dementia symptoms?

Rivastigmine works by increasing the levels of a natural brain chemical called acetylcholine. This chemical is essential for nerve cells to communicate in the brain, and people with dementia often have low levels of it. By increasing acetylcholine, rivastigmine can improve dementia symptoms.

How should I take rivastigmine capsules or liquid medicine to get the best effect?

It is usually recommended to take rivastigmine capsules or liquid medicine twice a day, ideally with or shortly after breakfast and your evening meal. Taking your doses at the same time each day can help you remember. Swallow capsules whole with a drink of water. If you're using the liquid, you can take it directly from the syringe or stirred into water.

What should I do if I forget to take a dose of rivastigmine?

If you forget a dose, take it as soon as you remember, unless it's almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular schedule. Never take two doses at once to make up for a forgotten one. If you miss several days of treatment, you should speak with your doctor before starting again, as you might need to begin on a lower dose.

Are there any specific instructions for applying rivastigmine skin patches?

Apply one patch each day to a non-hairy area of skin on your back, upper arm, or chest (avoiding the breast area). Press the patch firmly for about 30 seconds to ensure it sticks. Remember to remove the previous day's patch before applying a new one, and avoid using the same skin area for a new patch for at least 14 days. If the patches cause skin irritation, inform your doctor.

What should I tell my doctor or pharmacist before starting rivastigmine?

Before starting rivastigmine, it's important to inform your doctor or pharmacist if you have any liver or kidney problems, a heart condition, breathing issues like asthma or COPD, problems passing urine, a history of stomach or duodenal ulcers, or have ever experienced fits or seizures. Also, mention all other medicines you are taking, including over-the-counter or herbal remedies. Let them know if you've had an allergic reaction to any medicine in the past.

How will my doctor decide the correct dose of rivastigmine for me?

When you start treatment, your doctor will prescribe a small dose and gradually increase it. This allows them to find the most effective dose for your condition while minimising unwanted side-effects. Your progress will be checked regularly to confirm the dose is right and that you are benefiting from the treatment.

What should I do if I experience common side-effects like feeling sick or an upset tummy?

Common side-effects such as nausea, vomiting, indigestion, or tummy pain often improve over the first few days. If these continue or become troublesome, you should let your doctor know, as your treatment may need reviewing. For diarrhoea, drink plenty of water to prevent dehydration, and inform your doctor if it persists.

Lecturas adicionales y referencias

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About the authorView full bio

Author image

Michael Stewart, MRPharmS

Medicine Leaflet Review Manager – Contractor, Pharmacist

BPharm (Hons), MRPharmS

Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.

About the reviewer

Author image

Sid Dajani

Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.

Historial del artículo

La información en esta página está escrita y revisada por pares por clínicos calificados.

  • Próxima revisión: 28 Jun 2027
  • 29 Dic 2022 | Última versión

    Última actualización por

    Michael Stewart, MRPharmS

    Revisado por pares por

    Sid Dajani
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