From the Guidelines
Exelon (rivastigmine) is recommended for the treatment of mild to moderate dementia associated with Alzheimer's disease and Parkinson's disease, as it has been shown to have a statistically significant beneficial effect on cognitive function in some individual trials, although the overall summary effect is highly inconsistent 1.
Key Points
- Exelon works by increasing acetylcholine levels in the brain by inhibiting the enzyme acetylcholinesterase.
- It is available in several forms, including oral capsules, oral solution, and transdermal patches.
- Treatment typically starts at a low dose and gradually increases based on tolerance and response.
- Common side effects include nausea, vomiting, decreased appetite, and dizziness, which are often more pronounced with oral forms than patches.
Dosage and Administration
- For capsules, patients usually begin with 1.5mg twice daily with food, potentially increasing to 3-6mg twice daily.
- For patches, treatment often starts with the 4.6mg/24hr patch, potentially increasing to higher strengths.
Important Considerations
- The medication should be taken consistently as prescribed, and patients should not stop taking it without consulting their healthcare provider as sudden discontinuation can worsen symptoms.
- The effect on behavior and quality of life was not statistically significant in any study that evaluated these outcomes 1.
- Withdrawal rates related to adverse events ranged from 12% to 29% in the treatment group, with common adverse events including dizziness, nausea, vomiting, eating disorder/weight loss, and headache 1.
From the FDA Drug Label
Rivastigmine tartrate is an acetylcholinesterase inhibitor indicated for treatment of: • Mild-to-moderate dementia of the Alzheimer's type (AD) • Mild-to-moderate dementia associated with Parkinson's disease (PD)
The medication Exelon is rivastigmine, which is used to treat mild-to-moderate dementia associated with Alzheimer's disease and Parkinson's disease 2.
- Key points:
- Indications: Alzheimer's disease, Parkinson's disease dementia
- Dosage: 6 mg to 12 mg per day, administered twice a day
- Administration: With meals, in divided doses, in the morning and evening
- Titration: Increase dose after a minimum of 2 weeks for Alzheimer's disease and 4 weeks for Parkinson's disease dementia, if well tolerated 2.
From the Research
Exelon Medication Overview
- Exelon, also known as rivastigmine, is a medication used to treat mild to moderate Alzheimer's disease 3, 4, 5, 6, 7.
- It is a cholinesterase inhibitor that works by inhibiting the breakdown of acetylcholine, a neurotransmitter associated with memory 4, 6.
Efficacy of Exelon
- Studies have shown that Exelon is effective in improving cognitive function, activities of daily living, and global function in patients with mild to moderate Alzheimer's disease 3, 4, 5, 6, 7.
- Exelon has been shown to slow down the progression of cognitive decline in patients with Alzheimer's disease 5, 6.
- The medication has also been found to be beneficial in terms of clinician's global assessment, with a smaller proportion of patients experiencing no change or deterioration 6.
Safety and Tolerability of Exelon
- Exelon is generally well tolerated, with most adverse events being mild to moderate in severity 4, 5, 6, 7.
- Common adverse events associated with Exelon include nausea, vomiting, diarrhea, and application-site reactions 4, 6, 7.
- The transdermal patch formulation of Exelon has been found to have fewer side effects than the oral formulation, with comparable efficacy 6, 7.
Comparison with Other Cholinesterase Inhibitors
- Exelon has been compared with other cholinesterase inhibitors, such as donepezil and galantamine, in several studies 4, 6.
- The studies found that Exelon is efficacious for mild to moderate Alzheimer's disease, with no significant differences in efficacy between the three medications 4, 6.
- However, Exelon may have a higher risk of adverse events compared to donepezil, although the transdermal patch formulation may have fewer side effects 6, 7.