rivastigmine

CLINICAL USE

Mild-moderate dementia in Alzheimer’s diseaseIdiopathic Parkinson’s disease

DOSE IN NORMAL RENAL FUNCTION

3–6 mg twice daily (initially 1.5 mg twice daily)

PHARMACOKINETICS

Molecular weight :250.3 (400.4 as hydrogen tartrate)

%Protein binding :40

%Excreted unchanged in urine : 0 (>90 as pharmacologically inactive metabolites)

Volume of distribution (L/kg) :1.8–2.7

half-life – normal/ESRD (hrs) :1/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Start at a low dose and gradually increase

10 to 20 : Start at a low dose and gradually increase

<10 : Start at a low dose and gradually increase

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Likely dialysability. Dose as in GFR <10 mL/min

HD :Likely dialysability. Dose as in GFR <10 mL/min

HDF/high flux :Likely dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Likely dialysability. Dose as in GFR=10-20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsMuscle relaxants: enhances effect of suxamethonium; antagonises effect of non-depolarising muscle relaxants

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

Administer with food. Swallow whole .

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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