Rivastigmine Tartrate

Adults: Rivastigmine capsules are taken twice a day, with the morning and evening meals. Initial dose: Rivastigmine 1.5 mg twice a day. Dose titration: The starting dose is 1.5 mg twice a day. If the patient tolerates this well after at least two weeks of treatment, the dose may go up to 3 mg twice a day. The next increases, to 4.5 mg and then 6 mg twice a day, also depend on good tolerability of the current dose. Each one may be considered after at least two weeks at that dose level. Maintenance dose: The effective dose is 3 mg to 6 mg twice a day. To get the greatest benefit, patients should stay on the highest dose they tolerate well. The recommended maximum daily dose is 6 mg twice a day. Maintenance treatment can continue for as long as the patient is getting a therapeutic benefit. Re-initiation of therapy: If treatment is interrupted for more than several days, restart at 1.5 mg twice daily. Then carry out the dose titration as described above. Rivastigmine transdermal patch: Apply the patch on intact skin for a 24-hour period, and replace it with a new patch every 24 hours. Initial dose: Start with the 4.6 mg/24 hours Rivastigmine transdermal patch. Dose titration: After at least 4 weeks, if the patient tolerates it, increase the dose to 9.5 mg/24 hours, which is the minimum effective dose. After at least another 4 weeks, the dose may be increased to the maximum of 13.3 mg/24 hours. Mild to moderate Alzheimer's disease and Parkinson's disease dementia: Rivastigmine transdermal patch 9.5 mg/24 hours or 13.3 mg/24 hours once daily. Severe Alzheimer's disease: Rivastigmine transdermal patch 13.3 mg/24 hours once daily. If treatment is interrupted for longer than 3 days, start the titration again from 4.6 mg per 24 hours.