What is Exelon?

Rivastigmine is a prescription drug used to treat mild to moderate dementia associated with Alzheimer's and Parkinson's disease. It works by inhibiting the breakdown of acetylcholine, a key chemical messenger involved in memory and thinking.

How does Exelon Work?

Exelon works by inhibiting the enzyme acetylcholinesterase, which is responsible for breaking down acetylcholine. By inhibiting this enzyme, Exelon helps preserve existing stores of acetylcholine in the brain, allowing it to carry out its functions more effectively. This mode of action is thought to improve cognitive symptoms associated with Alzheimer's and Parkinson's disease such as memory loss, thinking ability, and reasoning.

Approved Uses and Dosing

Exelon is approved by the FDA for the treatment of mild to moderate dementia associated with Alzheimer's disease and mild to moderate Parkinson's disease dementia. It is available in oral capsule and transdermal patch dosage forms.

For Alzheimer's disease, Exelon capsules are usually started at 1.5 mg twice a day and increased gradually over several weeks up to a maximum of 6 mg twice daily. The transdermal patches are initially applied once daily at 4.6 mg/24 hours and the dose can be increased up to 9.5 mg/24 hours based on clinical response and tolerability.

For Parkinson's disease dementia, dosing follows the same approach but capsules can be increased up to a maximum of 12 mg daily in divided doses and patches can be increased to 13.3 mg/24 hours. Treatment should be continued as long as the patient shows a beneficial response to Exelon therapy.

Potential Side Effects

Like all medications, Exelon can potentially cause side effects in some patients. Common side effects reported in clinical trials include nausea, vomiting, diarrhea, weakness, and loss of appetite. These side effects are usually mild to moderate in severity and tend to diminish over time as the body adjusts to the medication. Other rarer but potentially serious side effects can include fainting, bradycardia (slow heart rate), and bronchospasm. As with any new medication, it's important to monitor the patient for side effects after starting treatment with Exelon and report any concerning symptoms to the doctor. Dose adjustments or temporary discontinuation may be needed in some cases to manage intolerable side effects.

Drug Interactions

Rivastigmine  can potentially interact with several other drugs by affecting their metabolism or effect. Patients should inform their doctor and pharmacist about all prescription medications, over-the-counter drugs, vitamins, and herbal supplements they are currently taking before starting Exelon therapy. Some common interactions to be aware of include increased effects of drugs that act on the central nervous system like antidepressants, benzodiazepines, and opiate pain medications. Exelon absorption is also reduced by antacids containing aluminum or magnesium hydroxide. Taking these medications at least 2 hours before or after Exelon dosing can help minimize interactions. Close monitoring is important when combining Exelon with other drugs metabolized by the liver to avoid toxic effects.

Get more insights on - Rivastigmine