donepezil vs rivastigmine
Side-by-side comparison of donepezil and rivastigmine Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Aricept
Exelon
Donepezil is a medicine used to treat dementia caused by Alzheimer's disease. It can help improve memory and thinking.
Rivastigmine (Exelon) is a medicine that helps improve memory and thinking in people with dementia. It works by increasing a chemical in the brain that is important for these functions.
Donepezil treats dementia in people with Alzheimer's disease. It can help with mild, moderate, and severe forms of the disease. This medicine can improve memory, awareness, and the ability to function.
This medicine treats mild to moderate dementia caused by Alzheimer's disease. It also treats mild to moderate dementia linked to Parkinson's disease. Dementia affects memory, thinking, and the ability to do daily activities.
Donepezil works by increasing a chemical in the brain called acetylcholine. This chemical helps nerve cells communicate better. By increasing acetylcholine, donepezil can improve mental function in people with Alzheimer's.
Rivastigmine helps increase the amount of a chemical called acetylcholine in your brain. Acetylcholine is important for memory and thinking. By increasing this chemical, rivastigmine can help improve these functions in people with dementia.
- • Nausea
- • Diarrhea
- • Trouble sleeping
- • Vomiting
- • Muscle cramps
- • Nausea
- • Vomiting
- • Loss of appetite
- • Upset stomach
- • Weakness
- Falling 2,966
- Death 2,021
- Confusion 1,894
- Diarrhea 1,739
- Dizziness 1,733
- Death 2,176
- Fall 1,664
- Seeing or hearing things that are not there 1,365
- Confusion 1,258
- The medicine is not working 896
This medicine can slow your heart rate or cause fainting. Tell your doctor if you have heart problems. Donepezil can also cause nausea, vomiting, and stomach bleeding. Watch for these side effects, especially when you start taking it or when your dose is increased.
This medicine can cause significant nausea, vomiting, diarrhea, loss of appetite, and weight loss. These side effects can lead to dehydration, which can be serious. If you have a skin reaction that spreads, stop taking this medicine.
Talk to your doctor if you are pregnant or plan to become pregnant. This medicine may harm your unborn baby. It is not known if donepezil passes into breast milk, so talk to your doctor if you are breastfeeding.
It is not known if rivastigmine will harm an unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not known if rivastigmine passes into breast milk. Talk to your doctor about the best way to feed your baby if you are taking this medicine.
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How to Read This donepezil vs rivastigmine Comparison
donepezil is classified in the Acetylcholinesterase Inhibitor drug class, while rivastigmine sits within the Acetylcholinesterase Inhibitor class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, donepezil has 10,353 submissions while rivastigmine has 7,359. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between donepezil and rivastigmine — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.