Adult Dosing
Mild to moderate Alzheimer's dementia
- 3-6 mg PO bid
- Initial: 1.5 mg PO bid for at least 2 weeks
- Increase dose PRN at minimum of every 2 weeks
- Max: 12 mg/day
- Retitrate from 1.5 mg PO bid if therapy interrupted more than several days
- Give with food
Mild to moderate dementia associated with Parkinson’s disease a
- 1.5-6 mg PO bid
- Initial: 1.5 mg PO bid, increase dose by 1.5 mg q4 wks as tolerated
- Max: 12 mg/day
- Retitrate from 1.5 mg PO bid if therapy interrupted more than several days
Pediatric Dosing
- Safety and efficacy in pediatric patients has not been established
[Outline]
Renal Dose Adjustment (Based on CrCl)
- <50 mL/min: Consider lower doses
Hepatic Dose Adjustment
- Child-Pugh score 5-9: Consider lower doses
- Severe hepatic impairment: Dose adjustments not defined
- Therapy may cause significant gastrointestinal adverse reactions, including nausea and vomiting, anorexia, and weight loss. Therefore start therapy at a dose of 1.5 mg BID and titrate to the maintenance dose. Retitrate from 1.5 mg PO bid if therapy interrupted more than several days
- Therapy may increase gastric acid secretion due to increased cholinergic activity. Therefore patients should be monitored closely for symptoms of active or occult gastrointestinal bleeding, especially those at increased risk for developing ulcers and concurrent nonsteroidal antiinflammatory drugs
- Rivastgmine may exaggerate succinylcholine type muscle relaxation during anesthesia
- Therapy may have vagotonic effects on heart rate (e.g., bradycardia)
- Therapy has some potential for causing seizures. However, seizure activity also may be a manifestation of Alzheimer's Disease
- Cautiously administer in patients with a history of asthma or obstructive pulmonary disease
- Hypersensitivity reactions of the skin has been reported with rivastigmine. Discontinue rivastigmine in case of disseminated hypersensitivity reaction of the skin, which may occur after oral or transdermal administration
Cautions: Use cautiously in
- Cardiac conduction defects
- Bradyarrhythmias
- Sick sinus syndrome
- Asthma or COPD
- PUD or GI bleed history
- Risk factors for PUD or GI bleed
- Concurrent NSAID use
- Urinary obstruction
- Seizure history or risk
Pregnancy Category:B
Breastfeeding: Safety unknown.
Pricing data from www.DrugStore.com in U.S.A.
- Exelon 3 MG CAPS [Bottle] (NOVARTIS)
60 mg = $256.82
180 mg = $739.9 - Exelon 1.5 MG CAPS [Bottle] (NOVARTIS)
60 mg = $266.86
180 mg = $770.11 - Exelon 6 MG CAPS [Bottle] (NOVARTIS)
60 mg = $256.96
180 mg = $740.24 - Exelon 4.5 MG CAPS [Bottle] (NOVARTIS)
60 mg = $258.37
180 mg = $740.24
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
