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Rivastigmine

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  • the second cholinesterase inhibitor to be marketed in the UK for the treatment of Alzheimer's dementia

  • an acetylcholinesterase and butyrylcholinesterase inhibitor, licensed in the UK. It is licensed for symptomatic treatment of people with mild to moderately severe Alzheimer's dementia. The usual maintenance dosage is 3-6 mg twice daily

  • rivastigmine, in a dose of 6 mg or more daily, has been shown, in some patients, to slow the rate of decline in cognitive and global functioning more than placebo. However it is unclear as to how to assess which patients will benefit

  • typical side effects of donepezil, galantamine and rivastigmine are related to the gastrointestinal tract (including nausea and vomiting). These side effects are dose related and although they are usually short term they can lead to non-adherence. For full details of side effects and contraindications, see the Summaries of Product Characteristics.
  • see NICE guidance regarding the use of rivastigmine in Alzheimer's disease

Reference:

  1. NICE (November 2006).Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease

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