Initially 1.5 mg bd. May be increased if well tolerated after a min of 2 wk of treatment to 3 mg bd. Subsequent dose increase to 4.5 mg bd up to a max of 6 mg bd may be considered based on good tolerability of current dose. Patients sensitive to the effects of cholinergic drugs Initially 1 mg bd.
View Exelon overdosage for action to be taken in the event of an overdose.
Administration
Should be taken with food.
Contraindications
Hypersensitivity to rivastigmine or to other carbamate derivatives. History of application site reactions suggestive of allergic contact dermatitis w/ rivastigmine transdermal patch.
If treatment is interrupted for >3 days, it should be re-initiated w/ lowest daily dose. GI disorders may occur at initiation of therapy & shortly after dose increase. Monitor patient's wt during therapy. Sick sinus syndrome, conduction defects (SA & AV blocks); predisposed to increased gastric acid secretion, urinary obstruction & seizures; history of asthma or obstructive pulmonary disease. May induce or exacerbate extrapyramidal symptoms. Discontinue if allergic contact dermatitis occur. Patient <50 kg body wt. Hepatic & renal impairment. May impair ability to drive or operate machinery. Pregnancy & lactation. Ped patient.
Possible additive extrapyramidal effect w/ metoclopramide. Additive effects w/ other cholinomimetic drugs; anticholinergic drugs (eg, oxybutynin, tolterodine). May exaggerate the effects of succinylcholine-type muscle relaxants during anaesth. Additive effects leading to bradycardia w/ β-blockers. Increased oral clearance w/ nicotine.
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