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What is the most important information I should know about rivastigmine?

Before taking rivastigmine, tell your doctor if you have a heart rhythm disorder such as "sick sinus syndrome” (slow heartbeats), an enlarged prostate, urination problems, asthma, obstructive pulmonary disease, or a seizure disorder such as epilepsy.

Stop using rivastigmine and call your doctor at once if the medicine causes you to have stomach pain, nausea and vomiting, and loss of appetite.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

It is important to use rivastigmine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

If you stop taking rivastigmine for any reason, do not restart the medication without talking to your doctor first. You may need to restart treatment with a lower dose.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking rivastigmine.

Rivastigmine 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.

Warning

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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What is rivastigmine?

Rivastigmine improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.

Rivastigmine is used to treat mild to moderate dementia caused by Alzheimer’s or Parkinson’s disease.

Rivastigmine may also be used for other purposes not listed in this medication guide.


Precautions

Before taking rivastigmine, tell your doctor if you have:

  • a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats);
  • an enlarged prostate or urination problems;
  • epilepsy or other seizure disorder; or
  • asthma or obstructive pulmonary disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take rivastigmine.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether rivastigmine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Rivastigmine 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.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include severe nausea, vomiting, drooling, sweating, blurred vision, feeling light-headed, slow heartbeat, shallow breathing, muscle weakness, fainting, or seizure (convulsions).

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

If you miss several doses in a row, call your doctor before taking any more of this medication.

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Side-effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using rivastigmine and call your doctor at once if you have any of these serious side effects:

  • stomach pain, nausea and vomiting, loss of appetite;
  • black, bloody, or tarry stools;
  • coughing up blood or vomit that looks like blood or coffee grounds;
  • feeling light-headed, fainting;
  • chest pain;
  • confusion, agitation, extreme fear; or
  • pain or burning when you urinate.

Less serious side effects may include:

  • upset stomach, diarrhea;
  • weight loss;
  • weakness, dizziness;
  • swelling in your hands or feet;
  • joint pain;
  • cough, runny or stuffy nose;
  • increased sweating;
  • sleep problems (insomnia); or
  • headache.

This is not a complete list of side effects and other may occur. Tell your doctor about any unusual or bothersome side effect.

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Interactions

Before taking rivastigmine, tell your doctor if you are using any of 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); or
  • scopolamine (Transderm-Scop).

This list is not complete and there may be other drugs that can interact with rivastigmine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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