• Enhances cholinergic signaling: Rivastigmine is a reversible acetylcholinesterase inhibitor that increases acetylcholine levels

• Indicated for both Alzheimer’s & Parkinson’s dementia: Approved to manage cognitive impairment in mild-to-moderate cases of both types of neurodegenerative dementia.

   Flexible dose titration: Start at 1.5 mg twice daily (morning & evening meals); increase by 1.5 mg every 2 weeks to a maintenance range of 3 mg–6 mg twice daily based on tolerability. 

• Locally available & affordable: Offers an effective and accessible dementia option in Bangladesh. Approximate cost is ৳ 23 per capsule (~৳ 161 per strip of 7). 

ℹ️ Safety & Precautions

• Administration: Must be taken with food (breakfast and dinner) to reduce gastrointestinal side effects and enhance bioavailability. 

• Common side effects: Primarily gastrointestinal—nausea (~38%), vomiting (~23%), anorexia, weight loss, diarrhea. These are most frequent during dose escalation and tend to diminish with time. 

• Precautions:

  • Use caution in patients with cardiac conduction defects (e.g., sick sinus syndrome), asthma/COPD, seizure disorders, or urinary obstruction. May increase gastric acid secretion. 

• Drug interactions:

  • Should not be administered with other cholinomimetic agents or during anesthesia with succinylcholine-type relaxants due to additive cholinergic effects.

  • No significant interactions with digoxin, diazepam, warfarin, or fluoxetine observed. 

• Restarting after interruption: If therapy is paused for several days, restart at 1.5 mg twice daily before retitration. 

• Contraindications: Known hypersensitivity to rivastigmine or other carbamate derivatives, severe hepatic impairment, and active ulcer disease. 

📝 Dosage Guide

Typically, efficacy may become noticeable within a few weeks, but maximum benefit may take 3–6 months. 

❗ Quick Summary

• Active Ingredient: Rivastigmine Tartrate 1.5 mg

• Therapeutic Class: Cholinesterase inhibitor for dementia

• Indications: Mild to moderate Alzheimer’s dementia and Parkinson’s related dementia

• Adverse Events: Gastrointestinal discomfort (nausea, vomiting, diarrhea), weight loss

• Administration Tips: Twice daily with meals; titrate slowly

• Typical Cost (BD): ~৳ 23 per capsule; strip ~৳ 161

• Availability: Prescription-only; widely accessible in Bangladesh pharmacies

• Storage: Store below 30 °C, in dry, light-protected place; keep away from children.