Rivatig 1.5

Introduction
Rivatig 1.5 is used to treat mild to moderate dementia in Alzheimer’s disease, a progressive illness which gradually affects memory and thinking. It is also used to treat Parkinson’s disease. It does not cure these illnesses but may help improve memory, awareness and other symptoms. Your doctor will explain how to take Rivatig 1.5 and give you the one most suitable for you. Follow the instructions carefully to get the most benefit. The dose may change from time to time to suit your individual needs. You may take it with food, preferably at night before going to bed. It can take up to few weeks for symptoms to improve so keep taking your medicine regularly. You should not stop taking this medicine without consulting your doctor. Some common side effects of this medicine include nausea, vomiting and indigestion. Some people may experience dizziness, restlessness and anxious. You may have side effects more often when you start your treatment or when your dose is increased. Usually, the side effects will slowly go away as your body gets used to the Rivatig 1.5. If they are severe or will not go away, you should contact your doctor. Before using Rivatig 1.5, you should tell your doctor if you’ve ever had heart problems, stomach ulcer, epilepsy or asthma. It may also affect, or be affected by, some other drugs you are using so let your doctor know what these are to be safe. During pregnancy this medicine should only be taken if it is advised.

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Uses of Rivatig 1.5
Alzheimer's disease
Side effects of Rivatig 1.5
Common
Vomiting
Nausea
Indigestion
How to use Rivatig 1.5
Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Rivatig 1.5 is to be taken with food.
How Rivatig 1.5 works
Memory loss in Alzheimer’s disease occurs due to disturbances of signal transmission in the brain. Rivatig 1.5 is a cholinesterase inhibitor. It works by increasing the levels of a chemical messenger (acetylcholine) involved in transmmission of nerve signals. This improves memory and thinking.
What if you forget to take Rivatig 1.5?
If you miss a dose of Rivatig 1.5, skip it and continue with your normal schedule. Do not double the dose.
Quick Tips
You have been prescribed Rivatig 1.5 to slow down the progression of Alzheimer’s disease.
It does not cure Alzheimer’s disease but may help improve brain function and ability to do daily activities.
It may cause diarrhea, nausea, and vomiting. Drink plenty of fluids to keep yourself hydrated while taking Rivatig 1.5.
Do not drive or do anything that requires mental focus until you know how Rivatig 1.5 affects you.
Be cautious while taking this medicine if you suffer from peptic ulcer as it may cause vomiting, stomach bleeding, stomach pain, or discomfort.
Inform your doctor if you experience seizures or convulsions while taking this medicine.
Brief Description
Indication
Severe dementia in Alzheimer’s disease, Parkinson Dementia
Administration
Should be taken with food.
Adult Dose
Alzheimer Dementia Oral Indicated for mild-to-moderate dementia of the Alzheimer’s type Initial: 1.5 mg PO q12hr Increase by 1.5 mg/dose q2Weeks; not to exceed 6 mg PO q12hr Maintenance: 3-6 mg PO q12hr (higher end may be more beneficial) Transdermal Indicated for mild, moderate, and severe dementia of the Alzheimer’s type Initial: Apply 4.6 mg q24hr Dose titration: May increase dose to 9.5 mg q24hr after a minimum 4 weeks if well tolerated; after an additional 4 weeks, may further increase to 13.3 mg patch if needed Mild-to-moderate Alzheimer disease: Effective dosage range is 9.5-13.3 mg/24 hr Moderate-to-severe Alzheimer disease: Effective dose is 13.3 mg/24 hr Replace with new patch q24hr Parkinson Dementia Oral Initial: 1.5 mg PO q12hr Increase by 1.5 mg/dose q4Weeks; not to exceed 6 mg PO q12hr Maintenance: 1.5-6 mg PO q12hr Transdermal Initial: Apply 4.6 mg q24hr May increase dose to 9.5 mg q24hr after a minimum 4 weeks if well tolerated; after an additional 4 weeks, may further increase to 13.3 mg patch if needed Transdermal Mild-to-moderate hepatic impairment: Not to exceed 4.6 mg q24hr

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Renal Dose
Transdermal Renal impairment: No dosage adjustment required

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Contraindication
Hypersensitivity to other carbamate derivatives. Severe hepatic impairment.
Mode of Action
Rivastigmine reversibly inhibits hydrolysis of acetylcholine by cholinesterases thus increasing acetylcholine present in the CNS. It is selective for the CNS and is used for the symptomatic treatment of dementia in Alzheimer’s disease and idiopathic Parkinson’s disease.
Precaution
Patients with sick sinus syndrome or conduction defects, resp diseases. Cholinergic stimulation may increase gastric acid secretion. May exacerbate urinary obstruction and seizures. Pregnancy. Renal impairment, mild to moderate hepatic impairment. Monitor body wt. Asthma or obstructive pulmonary disease. May worsen extrapyramidal symptoms. Lactation. Lactation: Unknown if excreted in milk; not recommended

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Side Effect
>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%) Potentially Fatal: Serious GI reactions such as anorexia, vomiting and weight loss.

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Interaction
Not to be used with other cholinomimetic drugs that might interfere with the activity of anticholinergic medications. May exaggerate the effects of succinylcholine-type muscle relaxants during anaesthesia. Tobacco smoking may increase its clearance.