Exelon

What is it?

A preparation that acts on the central nervous system, being an acetylcholinesterase inhibitor. Acetyl- cholinesterase is an enzyme which breaks down the neurotransmitter, acetylcholine (a substance that facilitates the transmission of nerve signals). A fall in the levels of acetylcholine is believed to be significant in the onset of symptoms of Alzheimer's dementia. Exelon is available in the form of capsules in 4 different strengths, all containing rivastigmine (as hydrogen tartrate), all marked with strength and name. Yellow capsules contain 1.5mg; orange capsules contain 3mg; red capsules contain 4.5mg; red/orange capsules contain 6mg. Also, EXELON ORAL SOLUTION, containing 2mg of rivastigmine, as hydrogen tartrate, per ml.

Medical Uses

Mild to moderate Alzheimer's disease.

Dosage

Adults, start with 1.5mg taken twice each day in the morning and evening, with meals. After at least 2 weeks, increase by 1.5mg to 3mg twice each day, as long as well tolerated. Then increase again in increments of 1.5mg at 2 weekly intervals, to 4.5mg and finally 6mg, both twice daily. 6mg twice each day is the maximum dose. Patient should continue to be treated with highest tolerated dose for 2 to 4 months and then condition should be reassessed. Therapy should only then be continued if there are definite benefits. If treatment is interrupted for a few days, for any reason, revert to 1.5mg dose and build up again gradually.

Special Care

Treatment only to commence under the supervision of physician who is an expert in Alzheimer's disease and who has established the diagnosis. Special care in pregnancy, asthma, kidney and liver disorders, sick sinus syndrome, obstructive pulmonary disease, predisposition to fits, at risk of, or previous gastrointestinal ulcers, obstruction of bladder outflow, conduction defects. Patient's weight should be monitored during course of therapy.

Avoid Use

Children, brerstfeeding, severe liver disease.

Possible Drug and Food Interactions

Chalinergic and antichelinergic drugs that block depolarising of neuromuscular membrane.

Known Side Effects

Headaches, dizziness, sleepiness, insomnia, trembling, sweating, depression, anorexia, weight loss, weakness, malaise, infections in respiratory and urinary tracts, pains in abdomen, gastrointestinal upset, agitation, trauma. Rarely, ulcer in stomach or duodenum, fits, rash, fainting, angina, slow heartbeat, AV (heart) block.