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Precautions and Warnings With Rivastigmine

Specific Precautions and Warnings With Rivastigmine

Warnings and precautions to be aware of prior to taking rivastigmine include the following:
 
  • The medication can cause severe gastrointestinal reactions, including severe nausea and vomiting. To help avoid such problems, rivastigmine should always be started at the lowest dose and increased slowly. If you stop taking the drug for an extended period, your healthcare provider should recommend that you restart back at the lowest dose. Let your healthcare provider know if you develop severe gastrointestinal side effects at any time.
     
  • Rivastigmine can cause significant weight loss, probably due to other side effects of rivastigmine, such as nausea, vomiting, diarrhea, and loss of appetite. Be sure to let your healthcare provider know if you lose a significant amount of weight while taking the drug.
     
  • The medication may have effects on the heart, possibly causing a dangerously slow heart rate. This is probably more common in people with heart conditions, but can occur in people without any heart problems.
     
  • Rivastigmine may increase the production of stomach acid, thereby increasing the risk of stomach or intestinal ulcers. If you have an ulcer (or a history of ulcers), your healthcare provider should monitor you closely to make sure the drug is not making these problems worse.
     
  • The medication can impair the ability of the bladder to empty, possibly causing difficulty urinating. Let your healthcare provider know if you develop any bladder problems while taking rivastigmine.
     
  • Even though rivastigmine is approved to treat Parkinson's dementia, it can make some Parkinson's symptoms (such as tremors) worse. You and your healthcare provider may need to make a decision about whether the cognitive benefits of the drug are worth a worsening of the physical Parkinson's disease symptoms.
     
  • Rivastigmine could cause seizures or make seizures worse. However, Alzheimer's disease itself may also cause seizures.
     
  • The medication may cause a worsening of asthma symptoms. Check with your healthcare provider before taking rivastigmine if you have asthma.
     
  • If you have a surgery planned, make sure to let your surgeon and anesthesiologist know you are taking rivastigmine, as it can interact with some medications used during anesthesia.
     
  • Rivastigmine can potentially interact with several medications (see Drug Interactions With Rivastigmine).
     
  • Rivastigmine is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are not known (see Exelon and Pregnancy).
     
  • It is not known whether rivastigmine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Exelon and Breastfeeding).
     
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