Rivamer Capsule
Rivastigmine
4.5mg
Sun Pharmaceutical (Bangladesh) Ltd.
| Pack size | 30's pack |
|---|---|
| Unite Price | 40.13 BDT |
Indications
Rivamer Capsule is used for:
Severe dementia in Alzheimer's disease, Parkinson Dementia
Adult Dose
Alzheimer Dementia
Oral
Indicated for mild-to-moderate dementia of the Alzheimer's type
Initial: 1.5 mg PO q12hr
Increase by 1.5 mg/dose q2Weeks; not to exceed 6 mg PO q12hr
Maintenance: 3-6 mg PO q12hr (higher end may be more beneficial)
Transdermal
Indicated for mild, moderate, and severe dementia of the Alzheimer's type
Initial: Apply 4.6 mg q24hr
Dose titration: May increase dose to 9.5 mg q24hr after a minimum 4 weeks if well tolerated; after an additional 4 weeks, may further increase to 13.3 mg patch if needed
Mild-to-moderate Alzheimer disease: Effective dosage range is 9.5-13.3 mg/24 hr
Moderate-to-severe Alzheimer disease: Effective dose is 13.3 mg/24 hr
Replace with new patch q24hr
Parkinson Dementia
Oral
Initial: 1.5 mg PO q12hr
Increase by 1.5 mg/dose q4Weeks; not to exceed 6 mg PO q12hr
Maintenance: 1.5-6 mg PO q12hr
Transdermal
Initial: Apply 4.6 mg q24hr
May increase dose to 9.5 mg q24hr after a minimum 4 weeks if well tolerated; after an additional 4 weeks, may further increase to 13.3 mg patch if needed
Transdermal
Mild-to-moderate hepatic impairment: Not to exceed 4.6 mg q24hr
Child Dose
Renal Dose
Transdermal
Renal impairment: No dosage adjustment required
Administration
Should be taken with food.
Contra Indications
Hypersensitivity to other carbamate derivatives. Severe hepatic impairment.
Precautions
Patients with sick sinus syndrome or conduction defects, resp diseases. Cholinergic stimulation may increase gastric acid secretion. May exacerbate urinary obstruction and seizures. Pregnancy. Renal impairment, mild to moderate hepatic impairment. Monitor body wt. Asthma or obstructive pulmonary disease. May worsen extrapyramidal symptoms. Lactation.
Lactation: Unknown if excreted in milk; not recommended
Pregnancy-Lactation
Pregnancy
There are no adequate data on developmental risks associated with use of drug in pregnant women
Animal data
In animals, no adverse effects on embryo-fetal development were observed at oral doses 2-4 times maximum recommended human dose (MRHD)
Lactation
There are no data on presence of drug in human milk, effects on breastfed infant, or on milk production; the drug and its metabolites are excreted in rat milk following oral administration of rivastigmine; levels of rivastigmine plus metabolites in rat milk are approximately 2 times that in maternal plasma; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or underlying maternal condition
Interactions
Not to be used with other cholinomimetic drugs that might interfere with the activity of anticholinergic medications. May exaggerate the effects of succinylcholine-type muscle relaxants during anaesthesia. Tobacco smoking may increase its clearance.
Side Effects
Side effects of Rivastigmine :
>10%
Nausea (PO 47%; patch 21%), Vomiting (PO 31%; patch 6-19%), Dizziness (PO 21%; patch 2-7%), Diarrhea (PO 19%; patch 6-10%), Headache (PO 17%; patch 3-4%), Anorexia (PO 17%; patch 3-9%), Abdominal pain (PO 13%; patch 2-4%)
1-10%
Decreased weight (3-8%), Insomnia (PO 9%; patch 1-4%), Anxiety (PO 5%; patch 3%), Asthenia (PO 6%; patch 2-3%), Vertigo (2%), Fatigue (2%)
Potentially Fatal: Serious GI reactions such as anorexia, vomiting and weight loss.
Mode of Action
Rivastigmine reversibly inhibits hydrolysis of acetylcholine by cholinesterases thus increasing acetylcholine present in the CNS. It is selective for the CNS and is used for the symptomatic treatment of dementia in Alzheimer's disease and idiopathic Parkinson's disease.
Note
Rivamer 4.5mg Capsule generic name is Rivastigmine. Rivamer 4.5mg Capsule is manufactured by Sun Pharmaceutical (Bangladesh) Ltd.Rivamer is availble in all over Bangladesh.
Mes BD drug index information on Rivamer Capsule is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.