Classes
DEA Class; Rx
Common Brand Names; Exelon, Exelon Patch
- Acetylcholinesterase Inhibitors, Central;
- Cholinesterase Inhibitors
Description
Oral and transdermal cholinesterase inhibitor
Oral and transdermal formulations approved for mild to moderate dementia due to Alzheimer’s or Parkinson’s disease; transdermal patch also approved for severe Alzheimer’s disease; may provide cognitive benefit in dementia with Lewy bodies
Requires slow dosage titration to limit GI side effects
Indications
For the treatment of mild to moderate Parkinson’s disease dementia
For the treatment of Alzheimer’s disease.
For the treatment of severe Alzheimer’s disease.
For the treatment of Dementia with Lewy bodies
For the treatment of vascular dementia
Contraindications
Hypersensitivity to rivastigmine or carbamates
History of application site reaction with transdermal patch
Active GI bleeding
Adverse Effects
>10%
- Nausea (PO 47%; patch 21%)
- Vomiting (PO 31%; patch 6-19%)
- Dizziness (PO 21%; patch 2-7%)
- Diarrhea (PO 19%; patch 6-10%)
- Headache (PO 17%; patch 3-4%)
- Anorexia (PO 17%; patch 3-9%)
- Abdominal pain (PO 13%; patch 2-4%)
1-10%
- Decreased weight (3-8%)
- Insomnia (PO 9%; patch 1-4%)
- Anxiety (PO 5%; patch 3%)
- Asthenia (PO 6%; patch 2-3%)
- Vertigo (2%)
- Fatigue (2%)
Cardiac Disorders: Tachycardia
Hepatobiliary Disorders: Abnormal liver function tests, hepatitis
Nervous System Disorders: Seizure
Psychiatric Disorders: Aggression, nightmares
Skin and Subcutaneous Tissue Disorders: Allergic dermatitis, application site hypersensitivity (patch), blister, disseminated allergic dermatitis, Stevens-Johnson syndrome, urticarial
Warnings
Anorexia
Sick sinus syndrome
History of peptic ulcer
History of asthma/COPD
May induce/exacerbate extrapyramidal symptoms
Pregnancy and Lactation
There are no adequate data on developmental risks associated with use of drug in pregnant women
There are no data on presence of drug in human milk, effects on breastfed infant, or on milk production
Maximum Dosage
12 mg/day PO; 13.3 mg/24 hours transdermally.
12 mg/day PO; 13.3 mg/24 hours transdermally.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.