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Rivastigmine

Last updated on 15/07/2021.

Overview   |   Dosage   |    Side Effects   |   Precautions   |   Tips   |   Where To Buy  

GENERIC NAME: Rivastigmine

CHINESE NAME: 卡巴拉汀

BRAND NAME(S) IN HONG KONG: Exelon 憶思能, Rivasan, Rivetal

DRUG CLASS: Central nervous system agents

SUB CLASS: Acetylcholinesterase inhibitors

USED FOR: Dementia associated with Parkinson’s disease, Alzheimer’s disease

AVAILABLE DOSAGE FORMS:
– 1.5 mg, 3 mg, 4.5 mg, 6 mg (capsules)
– 4.6 mg/24h, 9.5 mg/24h, 13.3 mg/24h, (patch)
– 3 mg, 4.5 mg, 6 mg (tablets)

What is Rivastigmine for?

Rivastigmine belongs to a class of medications called central nervous system agents inhibiting an enzyme acetylcholinesterase to slow down the breakdown of a neurotransmitter acetylcholine. Rivastigmine is used for treating dementia associated with Parkinson’s disease and Alzheimer’s disease.

How to use it?

Rivastigmine is available as oral tablets, capsules and transdermal patches in Hong Kong. They should not be broken, crushed or chewed. The oral ones are taken with meals. The capsules should be swallowed as a whole.

Alzheimer’s disease
Adult and elderly
Oral capsules or tablets: The initial dose is 1.5 mg twice daily and increases by 1.5 mg at least after two weeks. The usual dose is 3-6 mg twice daily. Start again from 1.5 mg twice daily if the treatment is interrupted for several days.
Transdermal patches: The initial dose is 4.6 mg daily and increases to 9.5 mg at least after 4 weeks, then 13.3 mg at least after 6 months. Start again from 4.6 mg daily if the treatment is interrupted for several days.

Dementia associated with Parkinson’s disease
Adult and elderly
Oral capsules or tablets: The initial dose is 1.5 mg twice daily and increases by 1.5 mg at least after two weeks. The usual dose is 3-6 mg twice daily. Start again from 1.5 mg twice daily if the treatment is interrupted for several days.
Transdermal patches: The initial dose is 4.6 mg daily and increases to 9.5 mg at least after 4 weeks, then 13.3 mg if necessary. Start again from 4.6 mg daily if the treatment is interrupted for several days.

What are the side effects of Rivastigmine?

Common side effects of Rivastigmine include dizziness, headache, weight loss, nausea and vomiting, tremor and fatigue.

Who should not take Rivastigmine?

– People allergic to Rivastigmine, other carbamate derivatives or any component of the formulation.
– People with a history of application-site reactions with Rivastigmine patches.
– Patients with severe liver impairment.
– People with a history of severe skin reactions with oral or transdermal Rivastigmine.

Pharmacist Tips:

– Do not break, crush or chew the tablets.
– Apply the transdermal patches after shower onto clean and hairless skin.
– Do not apply to the same area until after 14 days.
– There are usually behavioural symptoms like anxiety and anger in Alzheimer’s patients. Identify the triggers and avoid them.
– Change the environment to make Alzheimer’s patients feel more comfortable and secure if needed.
– Avoid arguing about facts with Alzheimer’s patients.

Common dosing schedule:
Oral Rivastigmine is usually taken twice daily with meals, preferably breakfast and dinner.

Transdermal Rivastigmine patches are applied every day, preferably after shower.

This schedule is for reference only, adjustments may be made according to individual needs. 

Some common medications Rivastigmine may interact with:
– Antipsychotic agents, e.g. Risperidone, Quetiapine, Clozapine
– Beta-blockers, e.g. Bisoprolol, Metoprolol, Propranolol
– Anticholinergic agents, e.g. Atropine, Benztropine, Benzhexol
– Cholinergic agonists, e.g. Pilocarpine, Donepezil, Parathion
– Corticosteroids, e.g. Hydrocortisone, Dexamethasone, Prednisolone

Rivastigmine may interact with many other medications. Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.

Where to buy Rivastigmine in Hong Kong?

In Hong Kong, Rivastigmine is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.

For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at https://www.drugoffice.gov.hk

Need more information?

For detailed information about the use of Rivastigmine in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.

Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.