Exelon
Generic Name: rivastigmine tartrate
Brand name: Exelon
Indications
Exelon (rivastigmine tartrate) is indicated for the treatment of mild to moderate dementia of the Alzheimer's type.
Exelon (rivastigmine tartrate) is indicated for the treatment of mild to moderate dementia associated with Parkinson's disease.
Dosage and Administration
Exelon (rivastigmine tartrate) Capsules are available equivalent to 1.5 mg, 3 mg, 4.5 mg, or 6 mg of rivastigmine base. It is also available as oral solution.
Normal Dosage:
Dementia of the Alzheimer's type: The dosage of Exelon (rivastigmine tartrate) shown to be effective in controlled clinical trials in Alzheimer's disease is 6-12 mg/day, given as twice-a-day dosing (daily doses of 3 to 6 mg BID). There is evidence from the clinical trials that doses at the higher end of this range may be more beneficial.
Dementia associated with Parkinson's disease: The dosage of Exelon shown to be effective in the single controlled clinical trial conducted in dementia associated with Parkinson's disease is 3 to 12 mg/day, given as twice-a-day dosing (daily doses of 1.5 to 6 mg BID). In that medical condition, the starting dose of Exelon is 1.5 mg BID; subsequently, the dose may be increased to 3 mg BID and further to 4.5 mg BID and 6 mg BID, based on tolerability, with a minimum of 4 weeks at each dose.
Overdose: Overdose symptoms may include severe nausea, vomiting, perspiration, blurred vision, shallow breathing, muscle weakness, and seizure (convulsions).
Drug Description
Exelon (rivastigmine tartrate) is a reversible cholinesterase inhibitor and is known chemically as (S)-N-Ethyl-N-methyl-3-[1-(dimethylamino)ethyl]-phenyl carbamate hydrogen-(2R,3R)-tartrate. Rivastigmine tartrate is commonly referred to in the pharmacological literature as SDZ ENA 713 or ENA 713. It has an empirical formula of C14H22N2O2•C4H6O6 (hydrogen tartrate salt - hta salt) and a molecular weight of 400.43 (hta salt). Rivastigmine tartrate is a white to off-white, fine crystalline powder that is very soluble in water, soluble in ethanol and acetonitrile, slightly soluble in n-octanol and very slightly soluble in ethyl acetate. The distribution coefficient at 37°C in n- octanol/phosphate buffer solution pH 7 is 3.0.
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Side Effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Disturbances of the gut such as nausea, vomiting, diarrhoea, indigestion or abdominal pain
- Decreased appetite and weight loss
- Dizziness
- Increased sweating
- Fatigue
- Weakness or loss of strength (asthenia)
- Agitation
- Headache
- Sleepiness (somnolence)
- Shaking, usually of the hands (tremor)
- Confusion
- Difficulty in sleeping (insomnia)
- Depression
- Fainting (syncope)
- Ulceration of the stomach or intestine
- Seizures
- Chest pain (angina)
- Rash
- False perceptions of things that are not really there (hallucinations)
- Worsening of Parkinson's symptoms
- Abnormal heart beats
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
Precautions
- Use caution when driving, operating machinery, or performing other hazardous activities.
- Exelon can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
- When starting treatment with this medicine the dose will be increased gradually to reduce the chances of side effects. Follow the instructions given by the doctor.
- If unwanted effects are experienced during treatment with the medicine, for example nausea, vomiting, abdominal pain, loss of appetite, weight loss, hallucinations, or worsening of tremor or other movement problems in people with Parkinson's disease, particularly if these occur after any dose increases, you should tell your doctor. These side effects usually improve if the dose of the medicine is decreased.
- If treatment is stopped for more than a few days it should be restarted at the lowest dose, as directed by your doctor.
- This medicine may cause dizziness and sleepiness. Patients will need to take care when performing potentially hazardous activites.
- People with Alzheimer's disease lose weight. This medicine may also cause weight loss. For this reason body weight should be regularly monitored in people taking this medicine.
Drug Interactions
Before taking this drug consult your doctor if you are taking the following drugs:
- atropine (Donnatal, and others)
- belladonna
- clidinium (Quarzan)
- dicyclomine (Bentyl)
- glycopyrrolate (Robinul)
- hyoscyamine (Anaspaz, Cystospaz, Levsin, and others)
- mepenzolate (Cantil)
- methantheline (Provocholine)
- methscopolamine (Pamine)
- propantheline (Pro-Banthine)
- scopolamine (Transderm-Scop).
