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Rivadem 4.5 Capsule 1 Strip
Rivadem 4.5 Capsule is used in adult patients to manage:
- mild to moderately severe Alzheimer’s dementia
- mild to moderately severe dementia with Parkinson’s disease
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✅ Description:
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.
Safety Advices
Alcohol
UNSAFE
Caution is advised when consuming alcohol with Rivadem 4.5.
Pregnancy
UNSAFE
Rivadem 4.5 is not recommended for use in pregnant women unless clearly necessary. Consult your doctor before taking it.
Breastfeeding
UNSAFE
Rivadem 4.5 is not recommended for use in breastfeeding women. Consult your doctor before taking it.
Driving
UNSAFE
Do not drive or operate any machines if you feel dizzy or somnolent (feeling sleepy) after taking Rivadem 4.5.
Kidney
CONSULT YOUR DOCTOR
Rivadem 4.5 should be used with caution in patients with impaired kidney function. Consult your doctor before taking Rivadem 4.5.
Liver
CONSULT YOUR DOCTOR
Rivadem 4.5 should be used with caution in patients having impaired liver function. Consult your doctor before taking Rivadem 4.5.
Relevant Products / প্রাসঙ্গিক পণ্য
✔️ Rivadem is indicated for the symptomatic treatment of mild to moderately severe dementia in:
- Alzheimer’s disease
- Idiopathic Parkinson’s disease-related dementia
✔️ Dosage & Administration of Rivadem 4.5
Capsule
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.
✔️ Overdose Management of Rivadem 4.5
Symptoms may include:
- Severe nausea, vomiting, diarrhea
- Hallucinations, hypertension
- Bradycardia or syncope
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
✔️ Side Effects of Rivadem 4.5
Most common:
Nausea (38%)
Vomiting (23%)
- Weight loss (more frequent in females)
- Dizziness
- Diarrhea
- Anorexia
- Headache
✔️ Drug Interactions
- May enhance the effects of succinylcholine-type muscle relaxants during anesthesia
- Should not be used with other cholinergic drugs
- May antagonize anticholinergic medications
- No significant interactions with digoxin, diazepam, warfarin, or fluoxetine
- Does not alter prothrombin time when used with warfarin
✔️ Contraindications
Known hypersensitivity to rivastigmine or other carbamate derivatives
✔️ Use with caution in patients with:
- Cardiac conduction issues (e.g. sick sinus syndrome)
- Respiratory diseases (e.g. asthma, COPD)
- History of seizures
- Peptic ulcer disease
- Urinary obstruction
- Renal/hepatic impairment (dose adjustment may be needed)
- May worsen extrapyramidal symptoms in Parkinson’s disease
- Monitor body weight regularly
Not recommended for children or during breastfeeding.
Use in pregnancy only if clearly necessary.
✔️ Storage Conditions
Store in a cool, dry place away from light
Keep out of reach of children
⚠️Disclaimer:
At ePharma, we’re committed to providing accurate and accessible health information. However, all content is intended for informational purposes only and should not replace medical advice from a qualified physician. Please consult your healthcare provider for personalized guidance. We aim to support, not substitute, the doctor-patient relationship.
