Rivadem 4.5 Capsule is used in adult patients to manage:
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Rivastigmine, a carbamate derivative structurally related to physostigmine, works by reversibly inhibiting acetylcholinesterase and butyrylcholinesterase, enzymes that degrade acetylcholine. This action increases acetylcholine levels at synapses, enhancing cholinergic transmission in the brain. Rivastigmine shows greater selectivity for central (brain) cholinesterase over peripheral forms, improving cognitive symptoms associated with dementia.
Caution is advised when consuming alcohol with Rivadem 4.5.
Rivadem 4.5 is not recommended for use in pregnant women unless clearly necessary. Consult your doctor before taking it.
Rivadem 4.5 is not recommended for use in breastfeeding women. Consult your doctor before taking it.
Do not drive or operate any machines if you feel dizzy or somnolent (feeling sleepy) after taking Rivadem 4.5.
Rivadem 4.5 should be used with caution in patients with impaired kidney function. Consult your doctor before taking Rivadem 4.5.
Rivadem 4.5 should be used with caution in patients having impaired liver function. Consult your doctor before taking Rivadem 4.5.
Starting dose: 1.5 mg twice daily with meals
Titration: If well tolerated after ≥2 weeks, increase to 3 mg twice daily; further increases to 4.5 mg and 6 mg twice daily may be considered at ≥2-week intervals, depending on tolerance.
Maintenance dose: 3–6 mg twice daily (maximum 12 mg/day)
If treatment is interrupted for several days, restart at 1.5 mg twice daily and retitrate accordingly. Take capsules with morning and evening meals to reduce GI side effects.
Symptoms may include:
Supportive care is recommended
Atropine (0.03 mg/kg IV) may be used in severe cases
Avoid scopolamine as an antidote
Do not administer another dose for at least 24 hours in an asymptomatic overdose
Most common:
Nausea (38%)
Vomiting (23%)
Known hypersensitivity to rivastigmine or other carbamate derivatives
Not recommended for children or during breastfeeding.
Use in pregnancy only if clearly necessary.
Store in a cool, dry place away from light
Keep out of reach of children
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