Treatment of mild-to-moderate dementia associated with Alzheimer's disease or Parkinson’s disease

A deficiency of cortical acetylcholine is thought to account for some of the symptoms of Alzheimer's disease and the dementia of Parkinson's disease; rivastigmine increases acetylcholine in the central nervous system through reversible inhibition of its hydrolysis by cholinesterase

Absorption- Tmax, Transdermal: 8 to 16 hours. Distribution- Protein binding: 40%; Vd: 1.8 to 2.7 L/kg. Metabolism- extensive via cholinesterases. Excretion- Fecal: less than 1%; Renal: greater than 90% (changed); Dialyzable: No (hemodialysis); No (peritoneal dialysis); Hemofiltration: No. Elimination Half Life: 3 hours.

Hypersensitivity to rivastigmine, other carbamate derivatives (eg, neostigmine, pyridostigmine, physostigmine), or other components of the formulation.

B [FDA.AUS]

Infant risk can not be ruled out.

Significant gastrointestinal adverse reactions including nausea vomiting, anorexia, and weight loss have been reported with the Exelon Patch at higher than recommended doses.

(Mild, moderate, severe) Initial, 4.6 mg/24 hours patch topically once daily; after a minimum of 4 weeks and good tolerability, may titrate dose to 9.5 mg/24 hours patch topically once daily. (Mild to moderate) Maintenance, 9.5 mg/24 hours patch topically once daily; after a minimum of 4 weeks and good tolerability, may titrate to MAX of 13.3 mg/24 hours patch topically once daily when no longer receiving therapeutic benefit at lower dose. (Severe) Maintenance, 13.3 mg/24 hours patch topically once daily after minimum 4 weeks and good tolerability at lower dose of 9.5 mg/24 hours.