Monograph Details

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Central Nervous System > Parkinsonism

EXELON ORAL SOLUTION

Manufacturer

Novartis Pharmaceuticals Corp

Legal Classification

Pharmacological Class

Reversible acetylcholinesterase inhibitor (carbamate deriv).

Generic Name

Rivastigmine (as tartrate) 2mg/mL.

Also

• EXELON
• EXELON PATCH

Indications

Mild to moderate dementia associated with Parkinson's disease.

Children

Not applicable.

Adults

Take with food in the AM and PM. May mix soln with water, fruit juice, or soda. Caps and soln may be interchanged at equal doses. Initially 1.5mg twice daily; if tolerated, may increase by 1.5mg twice daily at intervals of at least 4 weeks. Usual range: 3–12mg/day; max 12mg/day. If dose is not tolerated, suspend for several doses and restart at same or next lower dose. If stopped for more than several days restart at 1.5mg twice daily and retitrate. Patch: Apply to clean, dry, hairless intact skin. Rotate application site (allow 14 days before reapplying to same site). Initially apply one 4.6mg/24hours patch once daily; if tolerated, may increase to 9.5mg/24hours patch after 4 weeks at previous dose. Low body wt. (<50kg): monitor dose adjustments. Switching from capsules or oral solution: see literature.

Precautions

Monitor for nausea, vomiting, anorexia, weight loss, GI bleed. Sick sinus syndrome, other supraventricular conduction disturbances. Seizures. History or risk of ulcers. Urinary obstruction. Asthma. COPD. Pregnancy (Cat.B). Nursing mothers: not recommended.

Interactions

Antagonizes anticholinergics. May potentiate succinylcholine-type muscle relaxants, other cholinesterase inhibitors, cholinergic agonists. Monitor for GI bleed with NSAIDs.

Adverse Reactions

GI upset, dyspepsia, abdominal pain, dizziness, anorexia, weight loss, headache, fatigue, insomnia, asthenia, malaise, tremor, syncope, hyperhidrosis, cholinergic effects.

How Supplied

Caps—60, 500
Soln—120mL (w. dosing syringe)
Patches—30

Additional Resources

• Related Prescribing Note