Rivastigmine

The dose of rivastigmine can vary, but the recommended starting dose is 1.5 mg twice daily with food, increased gradually to the best tolerated dose. The highest dose recommended is 6 mg twice a day.

Rivastigmine should be taken twice a day, once with breakfast and once with the evening meal. The capsules must be swallowed whole and should be taken on a regular basis every day in order to be effective.

The oral solution can be withdrawn from its container using the syringe provided. It can be swallowed directly from the syringe or mixed with a small amount of water, cold fruit juice, or soda. If you mix it into a beverage, make sure to stir and drink the full amount.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Rivastigmine exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store rivastigmine at room temperature, away from direct sunlight and heat, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may decrease your appetite; it may cause headaches; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause nausea or, rarely, vomiting; occasionally, it may cause weight loss. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

1.5 mg
Each yellow hard-gelatin capsule, ink-printed in red with "ENA713 1.5MG" on the body of the capsule and nothing on the cap, contains 1.5 mg of rivastigmine (as rivastigmine hydrogen tartrate). Nonmedicinal ingredients: hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, silicon dioxine; capsule: gelatin, red iron oxide, titanium dioxide, and yellow iron oxide.

3 mg
Each orange hard-gelatin capsule, ink-printed in red with "ENA713 3MG" on the body of the capsule and nothing on the cap, contains 3 mg of rivastigmine (as rivastigmine hydrogen tartrate). Nonmedicinal ingredients: hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, silicon dioxine; capsule: gelatin, red iron oxide, titanium dioxide, and yellow iron oxide.

4.5 mg
Each red hard-gelatin capsule, ink-printed in white with "ENA713 4.5MG" on the body of the capsule and nothing on the cap, contains 4.5 mg of rivastigmine (as rivastigmine hydrogen tartrate). Nonmedicinal ingredients: hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, silicon dioxine; capsule: gelatin, red iron oxide, titanium dioxide, and yellow iron oxide.

6 mg
Each orange and red hard-gelatin capsule, ink-printed in red with "ENA713 6MG" on the body of the capsule and nothing on the cap, contains 6 mg of rivastigmine (as rivastigmine hydrogen tartrate). Nonmedicinal ingredients: hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, silicon dioxine; capsule: gelatin, red iron oxide, titanium dioxide, and yellow iron oxide.

Do not take Rivastigmine if you:

• are allergic to rivastigmine or any of the ingredients of the medication
• are allergic to medications that are similar to rivastigmine
• have severely reduced liver function

There may be an interaction between rivastigmine and any of the following:

• alcohol
• Amiodarone
• anticholinergic medications (e.g., Benztropine, Diphenhydramine, Oxybutynin)
• antihistamines (e.g., brompheniramine, Chlorpheniramine)
• antipsychotic medications (e.g., Aripiprazole, Chlorpromazine, Haloperidol)
• beta-blockers (e.g., Atenolol, Metoprolol, Propranolol)
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Verapamil)
• cholinergic medications (e.g., Bethanechol)
• corticosteroids (e.g., Dexamethasone, Hydrocortisone, Prednisone)

• Digoxin
• Dipyridamole
• Metoclopramide
• neuromuscular blocking agents (e.g., atracurium, pancuronium, succinylcholine)
• Octreotide
• other cholinesterase inhibitors (e.g., Donepezil, Galantamine)
• scopolamine
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Breathing conditions: Rivastigmine may cause breathing problems to worsen. If you have a history of Asthma or obstructive lung disease (e.g., emphysema, chronic Bronchitis), discuss with your doctor how Rivastigmine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Rivastigmine, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Rivastigmine may cause dizziness or drowsiness, mainly when starting treatment or increasing the dose. Your doctor will advise you whether it is safe for you to drive vehicles and operate machinery. If you feel dizzy or drowsy, do not drive, use machines, or perform any other tasks that require your attention.

Heart disease: People with certain types of heart disease (e.g., Congestive Heart Failure, Coronary Artery Disease) are more likely to experience symptoms of heart disease as a result of rivastigmine slowing down the heart rate. If you have heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Rivastigmine, and whether any special monitoring is needed.

Kidney function: If you have reduced kidney function or Kidney Disease, discuss with your doctor how Rivastigmine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Rivastigmine, and whether any special monitoring is needed.

Liver function: If you have liver problems, discuss with your doctor how Rivastigmine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Rivastigmine, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Rivastigmine. People with severely reduced liver function should not use Rivastigmine.

Low body weight: People who weigh less than 50 kg may experience more side effects than people who weigh more than 50 kg. Discuss with your doctor any concerns you may have about using rivastigmine.

Seizures: People who have a history of seizures may experience an increase in seizures when using rivastigmine. If you have a history of seizures, discuss with your doctor how Rivastigmine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stomach problems: The use of rivastigmine is associated with significant stomach side effects including nausea, vomiting, loss of appetite, and weight loss. If these side effects persist or bother you, speak to your doctor. If you have a history of stomach ulcers or are at risk of developing ulcers discuss with your doctor how Rivastigmine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Rivastigmine, and whether any special monitoring is needed.

Stopping and restarting treatment: If you miss more than several days' worth of treatment, talk to your doctor about how to safely restart the medication.

Surgery: If you are going to have surgery, make sure you let all the doctors, including dentists, know that you are using rivastigmine.

Pregnancy: Rivastigmine should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Rivastigmine, contact your doctor immediately.

Breast-feeding: It is not known if rivastigimine passes into breast milk. If you are a breast-feeding mother and are taking Rivastigmine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Rivastigmine have not been established for children.

This medication is typically used twice a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, simply skip it and then take the next dose at the regularly scheduled time. Do not double the next dose to catch up. The capsule of this medication should not be opened, crushed or chewed. It is preferable to take this medication with a meal or a snack in order to reduce adverse effects.