Rivastigmine
Alzest, Exelon, Prometax
Granskad av Sid DajaniSenast uppdaterad av Michael Stewart, MRPharmSSenast uppdaterad 29 Dec 2022
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Rivastigmine helps ease the symptoms of memory loss and dementia.
You will be given a small dose when you first start treatment. This will gradually be increased.
If you are taking the capsules or liquid medicine, take your doses after a meal.
If you are using the patches, make sure you remove the old patch before applying a new one.
Överblick
Rivastigmine is a medicine used to treat symptoms of dementia associated with Alzheimer's or Parkinson's disease.
It aims to slow the progression of symptoms and is prescribed by a specialist.
It is available as capsules, oral liquid, or skin patches, usually taken twice or applied once daily.
Share your full medical history with your doctor before starting treatment.
Common side effects include nausea, vomiting, dizziness, and headaches.
About rivastigmine
Typ av medicin | Anti-dementia medicine (an acetylcholinesterase inhibitor) |
Används för | Dementia associated with Alzheimer's disease or Parkinson's disease |
Även kallad | Almuriva®; Alzest®; Erastig®; Exelon®; Nimvastid®; Prometax® |
Tillgänglig som | Capsules, oral liquid medicine and skin patches |
Rivastigmine is used to treat the symptoms of dementia, such as memory loss. It is prescribed for people who have dementia which is associated with Alzheimer's disease or Parkinsons sjukdom.
Rivastigmine cannot cure dementia, but it can slow down the progression of the symptoms in some people. It works by increasing the level of a natural chemical called acetylcholine. This is a chemical which allows nerve cells in the brain to communicate with each other, and it is known that people with dementia have low levels of it. The symptoms of dementia can be improved by increasing the levels of acetylcholine.
Rivastigmine will be prescribed by a specialist doctor. If you are a caregiver, please read this leaflet on behalf of the person who is receiving rivastigmine.
Before taking rivastigmine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking rivastigmine it is important that your doctor or pharmacist knows:
Om du har lever- eller njurproblem.
Om du har en hjärtsjukdom.
If you have any problems with your breathing, such as asthma or chronic obstructive pulmonary disease (COPD).
If you have any problems passing urine.
If you have ever had a stomach (gastric) or duodenal ulcer.
If you have ever had fits (convulsions or seizures).
Om du tar eller använder några andra läkemedel. Detta inkluderar alla läkemedel du tar som finns att köpa utan recept, samt växtbaserade och komplementära läkemedel.
Om du någonsin har haft en allergisk reaktion mot en medicin.
How to take rivastigmine
Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about rivastigmine and a full list of side-effects which you may experience from it.
Your caregiver will help you take your medicine exactly as your doctor has told you. It is usual to be prescribed two doses to take each day. Your dose will be written on the label of your pack to remind you.
There are several different strengths of rivastigmine capsules and patches available, so make sure the product you have been given is the strength you were expecting. If you are unsure, ask your pharmacist for advice.
Ideally the capsules or liquid medicine should be taken with, or soon after, your breakfast and your evening meal. Try to take your doses at the same times each day as this will help you to remember to take them.
If you have been prescribed capsules to take, you should swallow the capsule whole without chewing or crushing it. Taking your doses with a small drink of water may help.
If you forget to take a dose, take it as soon as you remember, unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
If you forget to take rivastigmine for several days, talk with your doctor before starting to take it again, as you may need to re-start your treatment on a lower dose.
If you have been prescribed skin patches, you will be asked to apply one patch each day. Make sure the previous day's patch is removed before you apply a new patch. If the patches cause any irritation to your skin, you should let your doctor know about this.
Taking rivastigmine oral liquid medicine
Read the manufacturer's instructions for the medicine you have been given.
Open the bottle and remove the oral dosing syringe and bottle adaptor provided.
Push the nozzle of the syringe into the bottle adaptor and insert it firmly into the top of the bottle.
Turn the bottle upside down.
Pull the plunger on the syringe a little way and push back up to get rid of any air bubbles. Then pull the plunger down to withdraw the required amount of medicine. Re-check your dose once you have removed the syringe from the bottle.
You can swallow the medicine straight from the syringe, or you can stir it into a glass of water to drink it.
When you have finished taking your dose, wipe the outside of the syringe with a tissue. The syringe can be cleaned in warm, soapy water.
Applying rivastigmine (Exelon®) patches
Open a packet and remove the patch from inside.
Apply the patch to an area of non-hairy skin on your back, upper arm, or chest (but not to your breast area). Press down on the patch with the palm of your hand for around 30 seconds. This will make sure it sticks firmly in place.
After 24 hours, remove the patch and do not use the same area of skin to apply another patch to for at least 14 days.
Repeat this process each day, removing the previous day's patch before applying a new patch.
If you forget to apply a new patch for more than three days, talk with your doctor before applying another patch, as you may need a lower dose.
Få ut det mesta av din behandling
When starting your treatment your doctor will give you a small dose and then gradually increase the dose. This allows your doctor to make sure that you have the dose that helps your condition and avoids any unwanted side-effects.
Your doctor will want to check your progress every few weeks to make sure the dose is right for you and that you are getting benefit from this treatment. Try to keep these regular doctor's appointments.
If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking rivastigmine. This is because rivastigmine may affect the amount of any anaesthetic you may need.
If you buy any medicines, always check with a pharmacist that they are safe to take with your other medicines. Some medicines can interfere with the way rivastigmine works.
Can rivastigmine cause problems?
Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. The table below lists some of the most common ones associated with rivastigmine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve over the first few days of taking a new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
Common rivastigmine side-effects | Vad kan jag göra om jag upplever detta? |
Feeling sick (nausea) or being sick (vomiting), indigestion, tummy (abdominal) pain | Let your doctor know if this happens, as your treatment may need reviewing |
Diarré | Drink plenty of water to replace any lost fluids. Let your doctor know if it continues |
Feeling dizzy or tired | Be especially careful if you are using any tools or machines |
Huvudvärk | Drick mycket vatten och be din apotekare rekommendera en lämplig smärtstillande. Om huvudvärken fortsätter, kontakta din läkare |
Loss of appetite, losing weight, feeling anxious or agitated, trembling, falling, sweating, and skin reactions (with the patches) | Om något av dessa blir besvärligt, tala med din läkare |
Om du upplever några andra symtom som du tror kan bero på denna medicin, tala med din läkare eller apotekare.
How to store rivastigmine
Förvara alla läkemedel utom räckhåll och synhåll för barn.
Förvara på en sval, torr plats, borta från direkt värme och ljus.
Once opened, a bottle of the medicine only keeps for one month. Do not store it or use it after this time.
Viktig information om alla läkemedel
Viktig information om alla läkemedel
Ta aldrig mer än den föreskrivna dosen. Om du misstänker att du eller någon annan kan ha tagit en överdos av denna medicin, gå till akutmottagningen på ditt lokala sjukhus. Ta med behållaren, även om den är tom.
Denna medicin är för dig. Ge den aldrig till andra människor även om deras tillstånd verkar vara detsamma som ditt.
Behåll inte föråldrade eller oönskade mediciner. Ta dem till ditt lokala apotek som kommer att ta hand om dem åt dig.
Om du har några frågor om denna medicin, fråga din apotekare.
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Vanliga frågor
What should I do if I forget to take rivastigmine for several days?
If you miss taking rivastigmine for several days, you should consult your doctor before you restart the treatment. You might need to begin again at a lower dose to allow your body to readjust to the medicine.
How do I make sure I am taking the correct strength of rivastigmine?
There are various strengths of rivastigmine capsules and patches available. Always check that the product you have received matches the strength your doctor prescribed. If you have any doubts, ask your pharmacist for clarification.
What's the best way to clean the oral dosing syringe after taking liquid rivastigmine?
After using the oral dosing syringe for rivastigmine liquid medicine, wipe the outside with a tissue. The syringe can then be cleaned using warm, soapy water.
If I am using rivastigmine patches, how long should I wait before applying a new patch to the same skin area?
When using rivastigmine skin patches, you should not reuse the same area of skin for applying another patch for at least 14 days after removing the previous one. This helps prevent skin irritation.
What should I tell my doctor or dentist if I'm having an operation or dental work?
It is important to inform the person performing any operation or dental treatment that you are taking rivastigmine. This is because rivastigmine can affect the amount of anaesthetic you may require.
Vidare läsning och referenser
- Manufacturer's PIL, Rivastigmine Mylan 1.5 mg, 3 mg, 4.5 mg, 6 mg Hard Capsules; Mylan, The electronic Medicines Compendium. Dated April 2021.
- Manufacturer's PIL, Rivastigmine Rosemont 2 mg/ml Oral Solution; Rosemont Pharmaceuticals Ltd, The electronic Medicines Compendium. Dated September 2019.
- Manufacturer's PIL, Exelon® 4.6 mg/24h, 9.5 mg/24h, 13.3 mg/24h Transdermal Patch; Novartis Pharmaceuticals UK Ltd, The electronic Medicines Compendium. Dated November 2020.
- Mediciner Komplett BNF 89:e Utgåvan; Brittiska Läkarföreningen och Kungliga Farmaceutiska Sällskapet i Storbritannien, London.
Om författarenVisa fullständig biografi

Michael Stewart, MRPharmS
Ansvarig för granskning av medicinbroschyrer – Konsult, Apotekare
BPharm (Hons), MRPharmS
Michael är en apotekare som arbetar i Midlands och South Yorkshire med mer än 20 års erfarenhet av att ge råd om läkemedel och medicinska tillstånd. Han har en stark bakgrund inom vårdutbildning och har producerat och levererat utbildningskurser för apoteksteam och personal inom vårdboenden, inklusive sjuksköterskor. Han har också bidragit till apoteksrådgivande styrelser för hantering av mindre allvarliga tillstånd i samhället.
Om recensenten

Sid Dajani
Sultan Dajani tog examen vid London School of Pharmacy 1994 och blev den yngsta valda medlemmen i Royal Pharmaceutical Society-rådet sedan dess grundande 1842.
Artikelhistorik
Informationen på denna sida är skriven och granskad av kvalificerade kliniker.
Artikeln finns också på Engelska, Tyska, Spanska, Franska, Italienska, Portugisiska, Hindi, Hebreiska, Arabiska, och Svenska.
Next review due: 28 Jun 2027
29 Dec 2022 | Senaste versionen

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