The Medical Letter on Drugs and Therapeutics
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A Rivastigmine Patch for Dementia

Cholinesterase inhibitors are now used routinely in patients with dementia.1 Rivastigmine transdermal system (Exelon Patch – Novartis), a patch formulation of the cholinesterase inhibitor rivastigmine tartrate, has been approved by the FDA for treatment of mild to moderate dementia associated with Alzheimer’s or Parkinson’s disease. An oral formulation of rivastigmine tartrate has been available in the US since 2000,2 but gastrointestinal adverse effects possibly related to rapidly rising serum concentrations have limited its use.3

MECHANISM OF ACTION — Cognitive deficits in Alzheimer’s disease have been associated with degeneration of cholinergic neurons in the brain. Rivastigmine, a noncompetitive cholinesterase inhibitor with good penetration into the central nervous system, increases ... more      

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