Rivamer 1.5 mg (Capsule)
Medicine Details
| Category | Details |
|---|---|
| Generic | Rivastigmine tartrate |
| Company | Sun pharmaceutical bangladesh ltd |
| Also available as |
Indications
- Symptomatic treatment of mild to moderately severe Alzheimer's dementia
- Symptomatic treatment of mild to moderately severe dementia in patients with Idiopathic Parkinson's disease
Pharmacology
Rivastigmine is a carbamate derivative that is structurally related to physostigmine. It binds reversibly with and inactivates cholinesterase, preventing the hydrolysis of acetycholine, leading to increased concentration of acetylcholine at cholinergic synapses.
Dosage
- Rivastigmine Capsule:
- Initial dose: Rivastigmine 1.5 mg twice a day
- Dose Titration: Starting dose 1.5 mg, may increase to 3 mg, 4.5 mg, and then 6 mg twice a day
- Maintenance dose: 3 mg to 6 mg twice a day, with a recommended maximum daily dose of 6 mg twice a day
- Rivastigmine Transdermal Patch:
- Initial Dose: 4.6 mg/24 hours
- Dose Titration: Increase to 9.5 mg/24 hours, then to maximum dosage of 13.3 mg/24 hours
- Administration: Apply patch on intact skin for a 24-hour period; replace with a new patch every 24 hours
Administration
Rivastigmine should be administered twice a day, with morning and evening meals.
Interaction
Rivastigmine may exaggerate the effects of succinylcholine-type muscle relaxants during anaesthesia. Caution is recommended when selecting anaesthetic agents.
Contraindications
Contraindicated in patients with hypersensitivity to the active substance or other carbamate derivatives.
Side Effects
- Nausea (38%)
- Vomiting (23%)
- Susceptibility of female patients to gastrointestinal adverse reactions and weight loss
Pregnancy & Lactation
Rivastigmine should not be used during pregnancy unless clearly necessary. It is excreted into milk and should not be used during breastfeeding.
Precautions & Warnings
Patients with sick sinus syndrome or conduction defects, respiratory diseases, pregnancy, renal impairment, mild to moderate hepatic impairment, body weight monitoring, asthma or obstructive pulmonary disease, lactation.
Use in Special Populations
- Renal and hepatic impairment: Dosing recommendations should be closely followed for individual tolerability
- Use in children: Not recommended for use in children
Overdose Effects
- Most cases: Accidental overdose have not been associated with any clinical signs or symptoms
- Symptoms:
- Nausea
- Vomiting
- Diarrhoea
- Hypertension
- Hallucinations
- Bradycardia
- Syncope
- Treatment: In massive overdose, atropine can be used. An initial dose of 0.03 mg/kg intravenous atropine sulphate is recommended, with subsequent doses based on clinical response.
Therapeutic Class
Drugs for Dementia
Storage Conditions
Store in a cool and dry place, protected from light.