Two medicines, side by side
Rivastigmine vs galantamine
Rivastigmine and galantamine are both labeled for alzheimer's disease. Drugs@FDA records approvals of rivastigmine since 2000 and of galantamine since 2001. Pharmacies paid $0.164 per rivastigmine 1.5 mg capsule and $0.294 per galantamine hbr 4 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: Rivastigmine, “Although the precise mechanism of action of rivastigmine is unknown, it is thought to exert its therapeutic effect by enhancing cholinergic function.”; Galantamine, “Although the etiology of cognitive impairment in Alzheimer's disease (AD) is not fully understood, it has been reported that acetylcholine-producing neurons degenerate in the brains of patients with …”
Check it at the source: the rivastigmine FDA label on DailyMed (effective June 19, 2024); the galantamine FDA label on DailyMed (effective June 1, 2026).
Highlights of the rivastigmine record
Rivastigmine (Exelon) · label of June 19, 2024
Used for
From the label: indicationsRivastigmine tartrate capsules are an acetylcholinesterase inhibitor indicated for treatment of: Mild-to-moderate dementia of the Alzheimer’s type (AD) ( 1.1 ) Mild-to-moderate dementia associated with Parkinson’s disease (PD) ( 1.2 ) 1.1 Alzheimer’s Disease Rivastigmine tartrate capsules are indicated for the treatment of mild-to-moderate dementia of the Alzheimer's type (AD). 1.2 Parkinson’s Disease Dementia Rivastigmine tartrate capsules are indicated for the treatment of mild-to-moderate dementia associated with Parkinson’s disease (PD). […]
On the market
- Earliest approval on file
- April 21, 2000
- Generic labelers
- 18 labelers
- Pharmacy cost
- $0.164 per capsule
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 2
Highlights of the galantamine record
Galantamine (Razadyne) · label of June 1, 2026
Used for
From the label: indicationsGalantamine tablets are indicated for the treatment of mild to moderate dementia of the Alzheimer’s type. Galantamine Tables are a cholinesterase inhibitor indicated for the treatment of mild to moderate dementia of the Alzheimer’s type
On the market
- Earliest approval on file
- February 28, 2001
- Generic labelers
- 9 labelers
- Pharmacy cost
- $0.294 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Source: FDA drug labels via openFDA (Rivastigmine label of June 19, 2024, Galantamine label of June 1, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do rivastigmine and galantamine differ on the record?
How each works, in its label's words: Rivastigmine, “Although the precise mechanism of action of rivastigmine is unknown, it is thought to exert its therapeutic effect by enhancing cholinergic function.”; Galantamine, “Although the etiology of cognitive impairment in Alzheimer's disease (AD) is not fully understood, it has been reported that acetylcholine-producing neurons degenerate in the brains of patients with …”
Both are in FDA's class cholinesterase inhibitors.
Half-life, in each label's words: Rivastigmine, “The elimination half-life is about 1.5 hours, with most elimination as metabolites via the urine.”; Galantamine, “Galantamine has a terminal half-life of about 7 hours.”
Generics: rivastigmine since 2007; galantamine since 2008 (Drugs@FDA).
| Rivastigmine | Galantamine | |
|---|---|---|
| Labeled for | Alzheimer's disease | Alzheimer's disease |
| Pharmacologic class | Cholinesterase Inhibitor | Cholinesterase Inhibitor |
| How it works (label) | Although the precise mechanism of action of rivastigmine is unknown, it is thought to exert its therapeutic effect by enhancing cholinergic function. | Although the etiology of cognitive impairment in Alzheimer's disease (AD) is not fully understood, it has been reported that acetylcholine-producing neurons degenerate in the brains of patients with Alzheimer's disease. |
| Half-life (label) | The elimination half-life is about 1.5 hours, with most elimination as metabolites via the urine. | Galantamine has a terminal half-life of about 7 hours. |
| Earliest approval on file (Drugs@FDA) | April 21, 2000 | February 28, 2001 |
| First generic approved | October 22, 2007 | August 28, 2008 |
| Generic labelers (NDC) | 18 labelers | 9 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.164 per capsule (Rivastigmine 1.5 mg capsule) | $0.294 per tablet (Galantamine hbr 4 mg tablet) |
| 12-month price change | -11% | -10% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 2 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 19,159 | 3,188 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to rivastigmine
- every medicine labeled for the same conditions