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Parkinson & Alzheimers
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Rivastigmine
SELECT REF DESCRIPTION MANUFACTURER PACK SIZE STRENGTH OUR PRICE
J432 Rivastigmine Generic 10 tabs 3 mg $4.80
J532 Rivastigmine Generic 10 tabs 1.5 mg $6.25
J131 Exelon (Rivastigmine Tartrate) Generic 10 tabs 1.5 mg $7.11
P844 Rivamer (Rivastigmine) Sun Pharma 10 caps 1.5 mg $6.39
P845 Rivamer (Rivastigmine) Sun Pharma 10 caps 3 mg $8.23
P846 Rivamer (Rivastigmine) Sun Pharma 10 caps 4.5 mg $7.70
P847 Rivamer (Rivastigmine) Sun Pharma 10 caps 6 mg $7.25
Price is per pack & not per tab.. eg: if pack size is 10 tabs & price is $2.75 then for 100 tabs the price would be $27.50
What is rivastigmine?
Rivastigmine improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.

Rivastigmine is used to treat mild to moderate dementia caused by Alzheimer's or Parkinson's disease.

Rivastigmine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about rivastigmine?
Before taking rivastigmine, tell your doctor if you have a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats), an enlarged prostate, urination problems, asthma, obstructive pulmonary disease, or a seizure disorder such as epilepsy.

Stop using rivastigmine and call your doctor at once if the medicine causes you to have stomach pain, nausea and vomiting, and loss of appetite.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

It is important to use rivastigmine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

If you stop taking rivastigmine for any reason, do not restart the medication without talking to your doctor first. You may need to restart treatment with a lower dose.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking rivastigmine.

Rivastigmine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my healthcare provider before taking rivastigmine?

Before taking rivastigmine, tell your doctor if you have:

a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats);

an enlarged prostate or urination problems;

epilepsy or other seizure disorder; or

asthma or obstructive pulmonary disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take rivastigmine.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether rivastigmine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take rivastigmine?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Rivastigmine is usually taken twice a day, in the morning and evening. Follow your doctor's directions.

Take rivastigmine with food.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking rivastigmine. You may need to stop using the medicine for a short time.

Take the rivastigmine capsule with a full glass of water. Do not use a regular table spoon to measure a dose of rivastigmine oral liquid (solution). Use the syringe provided.

You may swallow the oral liquid directly from the syringe or mix the medicine with a small glass of water, fruit juice, or soda. Do not use any other liquids to mix with rivastigmine oral liquid.

Stir the medicine mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

After using the syringe, wipe the outside of it with a clean tissue and put the syringe back into its case. Close the medicine bottle using the child resistant closure.

It is important to use rivastigmine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

If you stop taking rivastigmine for any reason, do not restart the medication without talking to your doctor first. You may need to restart treatment with a lower dose.

Store rivastigmine at room temperature away from moisture and heat in an upright position.

What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

If you miss several doses in a row, call your doctor before taking any more of this medication.

What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include severe nausea, vomiting, drooling, sweating, blurred vision, feeling light-headed, slow heartbeat, shallow breathing, muscle weakness, fainting, or seizure (convulsions).

What should I avoid while taking rivastigmine?
Rivastigmine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Rivastigmine side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using rivastigmine and call your doctor at once if you have any of these serious side effects:

stomach pain, nausea and vomiting, loss of appetite;

black, bloody, or tarry stools;

coughing up blood or vomit that looks like blood or coffee grounds;

feeling light-headed, fainting;

chest pain;

confusion, agitation, extreme fear; or

pain or burning when you urinate.

Less serious side effects may include:

upset stomach, diarrhea;

weight loss;

weakness, dizziness;

swelling in your hands or feet;

joint pain;

cough, runny or stuffy nose;

increased sweating;

sleep problems (insomnia); or

headache.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Rivastigmine Dosing Information
Usual Adult Dose for Alzheimer's Disease:

Initial Oral Dose: 1.5 mg orally twice a day with morning and evening meals.

After a minimum of two weeks of treatment, if the initial dosage is well tolerated, it may be increased to 3 mg twice a day. Subsequent increases to 4.5 mg and 6 mg twice a day should be attempted only after a minimum of 2 weeks at the previous dosage. The dosage of rivastigmine shown to be effective in controlled clinical trials is 3 to 6 mg twice a day. There is evidence from the clinical trials that dosages at the higher end of this range may be more beneficial.

Initial Patch Dose: 4.6 mg/24 hours

After a minimum of four weeks of treatment and if well tolerated, the dose of the patch be increased to 9.5 mg/24 hours, which is the recommended effective dose.

Maintenance Patch Dose: Dose increases should occur only after a minimum of four weeks at the previous dose, and only if the previous dose has been well tolerated. The maximum recommended dose is 9.5 mg/ 24 hours. Higher doses confer no appreciable additional benefit, and are associated with significant increase in the incidence of adverse events.

Switching from Capsules or Oral Solution: Patients treated with capsules or oral solution may be switched to patches as follows:
A patient who is on a total daily dose of less than 6 mg of oral rivastigmine can be switched to patch dose of 4.6 mg/24 hours.
A patient who is on a total daily dose of 6 to 12 mg of oral rivastigmine may be directly switched to a patch dose of 9.5 mg/24 hours.
It is recommended to apply the first patch on the day following the last oral dose.

Usual Adult Dose for Parkinson's Disease:

Initial dose: 1.5 mg orally twice a day with morning and evening meals

Subsequently, the dose may be increased to 3 mg orally twice a day and further to 4.5 mg twice a day and 6 mg twice a day (based on tolerability) with a minimum of 4 weeks at each dose.

Initial Patch Dose: 4.6 mg/24 hours

After a minimum of four weeks of treatment and if well tolerated, the dose of the patch be increased to 9.5 mg/24 hours, which is the recommended effective dose.

Maintenance Patch Dose: Dose increases should occur only after a minimum of four weeks at the previous dose, and only if the previous dose has been well tolerated. The maximum recommended dose is 9.5 mg/ 24 hours. Higher doses confer no appreciable additional benefit, and are associated with significant increase in the incidence of adverse events.

Switching from Capsules or Oral Solution: Patients treated with capsules or oral solution may be switched to patches as follows:
A patient who is on a total daily dose of less than 6 mg of oral rivastigmine can be switched to patch dose of 4.6 mg/24 hours.
A patient who is on a total daily dose of 6 to 12 mg of oral rivastigmine may be directly switched to a patch dose of 9.5 mg/24 hours.
It is recommended to apply the first patch on the day following the last oral dose.

What other drugs will affect rivastigmine?
Before taking rivastigmine, tell your doctor if you are using any of the following drugs:

atropine (Donnatal, and others);

belladonna;

clidinium (Quarzan);

dicyclomine (Bentyl);

glycopyrrolate (Robinul);

hyoscyamine (Anaspaz, Cystospaz, Levsin, and others);

mepenzolate (Cantil);

methantheline (Provocholine);

methscopolamine (Pamine);

propantheline (Pro-Banthine); or

scopolamine (Transderm-Scop).

This list is not complete and there may be other drugs that can interact with rivastigmine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?
Your pharmacist can provide more information about rivastigmine.

 

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