II. Indications

III. Mechanism

  1. Carbamate-based noncompetitive cholinesterase inhibitor
  2. Inhibits butyrylcholinesterase and acetylcholinesterase
  3. Increases Cholinergic transmission

IV. Pharmacokinetics

  1. Peak: 1 hour
  2. Duration: 10 hours

V. Drug Interactions

  1. No significant drug interactions

VI. Efficacy

  1. Modestly improves scores on neuropsychological tests
  2. Benefits decrease after 40 weeks of treatment

VII. Adverse Effects

  1. Nausea or Vomiting
  2. Diarrhea
  3. Abdominal Pain
  4. Anorexia
  5. Weight loss
  6. No hepatotoxicity risk (contrast with Tacrine)

VIII. Dosing

  1. Initial: 1.5 mg PO bid with food
  2. Increase dose by 1.5 mg every 2 weeks up to 6 mg bid

IX. Cost

  1. (2003) Red Book: $130/month

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Cost: Medications

rivastigmine (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
RIVASTIGMINE 1.5 MG CAPSULE Generic $0.99 each
RIVASTIGMINE 13.3 MG/24HR PTCH Generic $7.45 each
RIVASTIGMINE 3 MG CAPSULE Generic $1.00 each
RIVASTIGMINE 4.5 MG CAPSULE Generic $0.93 each
RIVASTIGMINE 4.6 MG/24HR PATCH Generic $7.53 each
RIVASTIGMINE 6 MG CAPSULE Generic $0.88 each
RIVASTIGMINE 9.5 MG/24HR PATCH Generic $7.35 each
exelon (on 2/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
EXELON 13.3 MG/24HR PATCH Generic $7.45 each
EXELON 4.6 MG/24HR PATCH Generic $7.53 each
EXELON 9.5 MG/24HR PATCH Generic $7.35 each

Ontology: rivastigmine (C0649350)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C072506
SnomedCT 323368009, 395868008
English (S)-N-ethyl-3-((1-dimethyl-amino)ethyl)-N-methylphenylcarbamate, Carbamic acid, ethylmethyl-, 3-(1-(dimethylamino)ethyl)phenyl ester, (S)-, (R-(R*,R*))-2,3-dihydroxybutanedioate (1:1), rivastigmine, rivastigmine (medication), RIVASTIGMINE, rivastigmine [Chemical/Ingredient], Rivastigmine, Rivastigmine (product), Rivastigmine (substance)
Spanish rivastigmina (producto), rivastigmina (sustancia), rivastigmina

Ontology: Exelon (C0730987)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C072506
English Exelon, rivastigmine (Exelon), exelon