Prescription medication · Acetylcholinesterase Inhibitor
rivastigmine
Also sold as Exelon. This medicine treats mild to moderate dementia caused by Alzheimer's disease.
Data updated 2026-05-15
- 17,976
- FDA reportsModerately reported
- 4
- InteractionsFew interactions
- 99% less
- Generic vs brandHuge savings
- $21.97
- Brand price (NADAC)
What the data shows
rivastigmine (Exelon) is a prescription Acetylcholinesterase Inhibitor, reported at a middle-of-the-pack volume (17,976 FDA reports), whose generic costs a fraction of the brand (about 99% less).
Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.
rivastigmine (Exelon) is a prescription Acetylcholinesterase Inhibitor. This medicine treats mild to moderate dementia caused by Alzheimer's disease.
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.
Verify with FDA → · CMS NADAC pricing →
Drug Pricing (NADAC)
Brand Price
$21.97/unit
Generic Price
$0.16/unit
Generic Savings
99%
Generic Available
Yes (11 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
This medicine treats mild to moderate dementia caused by Alzheimer's disease.
Common side effects
Nausea, Vomiting, Loss of appetite
Key warnings
This medicine can cause significant nausea, vomiting, diarrhea, loss of appetite, and weight loss.
The sections below are summarized in plain English from rivastigmine's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.
How It Works
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.
How to Take It
Take rivastigmine capsules with food, in the morning and evening. For Alzheimer's, you'll likely start with 1.5 mg twice a day. Your doctor may increase the dose every 2 weeks to a maximum of 6 mg twice a day. For Parkinson's disease dementia, the dose may be increased every 4 weeks.
This is a plain-language summary of rivastigmine's FDA labeling, not individualized dosing advice. Ask a pharmacist or prescriber before changing how you take this medication.
Pregnancy & 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.
This is a plain-language summary of rivastigmine's FDA labeling, not individualized advice. Ask a pharmacist or prescriber about pregnancy or breastfeeding on this medication.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
This is a plain-language summary of rivastigmine's FDA labeling, not individualized advice. Ask a pharmacist or prescriber what to do about your specific missed dose.
Storage
Store rivastigmine capsules at room temperature, away from moisture and heat.
Side Effects (from patient reports)
Based on 17,976 FDA adverse event reports.
Most-reported reactions
Adverse reactions in FAERS for rivastigmine, by number of reports
- Death
Death
2,176 reports
- Fall
Fall
1,664 reports
- Seeing or hearing things that are not there
Seeing or hearing things that are not there
1,365 reports
- Confusion
Confusion
1,258 reports
- Throwing up
Throwing up
883 reports
- Feeling sick to your stomach 826
Feeling sick to your stomach
826 reports
- Feeling lightheaded 771
Feeling lightheaded
771 reports
- Trouble walking 713
Trouble walking
713 reports
- Lung infection 690
Lung infection
690 reports
- Feeling unwell 648
Feeling unwell
648 reports
What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.
Reports over time
Adverse-event reports filed for rivastigmine each year to the FDA Adverse Event Reporting System (FAERS).
Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.
Where rivastigmine sits
rivastigmine has more FDA adverse-event reports than 53% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.
Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is rivastigmine; the line is the median (50th percentile).
FDA Adverse Event Report Analysis
Detailed analysis of 17,976 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2000–2025.
Total Reports
17,976
Reports Mentioning Death
4,544
25.3% of reports — not proof of cause
Hospitalization Reports
6,537
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DEATH | 2,177 |
| 2 | FALL | 1,664 |
| 3 | HALLUCINATION | 1,365 |
| 4 | CONFUSIONAL STATE | 1,258 |
| 6 | VOMITING | 885 |
| 7 | NAUSEA | 827 |
| 8 | DIZZINESS | 771 |
| 9 | GAIT DISTURBANCE | 713 |
| 10 | PNEUMONIA | 690 |
| 11 | MALAISE | 648 |
| 12 | SOMNOLENCE | 646 |
| 13 | DIARRHOEA | 640 |
| 14 | FATIGUE | 637 |
| 15 | URINARY TRACT INFECTION | 610 |
| 16 | ASTHENIA | 609 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
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.
Known Drug Interactions
7 DRUG INTERACTIONS Concomitant use with metoclopramide, beta-blockers, or cholinomimetic and anticholinergic drugs is not recommended (7.1, 7.2, 7.3) 7.1 Metoclopramide Due to the risk of additive extrapyramidal adverse reactions, the concomitant use of metoclopramide and rivastigmine tartrate is not recommended.
Mechanism: Both drugs can cause similar side effects related to muscle control and movement. Taking them together increases the risk of developing shaky movements or muscle stiffness.
What to do: This combination is not recommended. Talk to your doctor about alternative treatments to avoid these movement-related side effects.
7.3 Beta-blockers Additive bradycardic effects resulting in syncope may occur when rivastigmine tartrate is used concomitantly with beta-blockers, especially cardioselective beta-blockers (including atenolol).
Mechanism: Both of these medicines can slow your heart rate. Taking them at the same time might cause your heart to beat too slowly or make you faint.
What to do: Watch for dizziness or fainting and have your doctor check your heart rate regularly.
7.2 Cholinomimetic and Anticholinergic Medications Rivastigmine tartrate may increase the cholinergic effects of other cholinomimetic medications and may also interfere with the activity of anticholinergic medications (e.g., oxybutynin, tolterodine).
Mechanism: These drugs have opposite effects on the body. Rivastigmine can prevent oxybutynin from working the way it is supposed to.
What to do: Tell your doctor if your symptoms return, as they may need to change your medications.
7.2 Cholinomimetic and Anticholinergic Medications Rivastigmine tartrate may increase the cholinergic effects of other cholinomimetic medications and may also interfere with the activity of anticholinergic medications (e.g., oxybutynin, tolterodine).
Mechanism: Rivastigmine works against drugs like tolterodine. This means tolterodine might not work as well when taken with rivastigmine.
What to do: Your healthcare provider should monitor how well your medications are working and adjust them if needed.
This is a plain-language summary of interactions documented in FDA labeling, not individualized advice. Ask a pharmacist or prescriber before combining medications.
Common Questions
What should I do if I feel sick to my stomach after taking this medicine?
Can I take this medicine with other medicines?
How long will I need to take this medicine?
What happens if I stop taking rivastigmine?
Will this medicine cure my dementia?
Can I drive while taking this medicine?
What if I accidentally take too much rivastigmine?
How long does it take for this medicine to start working?
Can my family member give me this medication even if I forget?
What are the common side effects of rivastigmine?
Does rivastigmine interact with other medications?
What drug class is rivastigmine?
Is there a generic version of rivastigmine?
Is rivastigmine safe during pregnancy?
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Medication Guides
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Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for rivastigmine
The FDA label for rivastigmine (sold under brand names such as Exelon) classifies it as a prescription-only medication in the Acetylcholinesterase Inhibitor class. This medicine treats mild to moderate dementia caused by Alzheimer's disease. Official labeling lists 5 commonly reported side effects, including Nausea, Vomiting, Loss of appetite.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 17,976 voluntary reports. The database also lists 4 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.16 versus $21.97 for the brand - a 99% generic savings.
Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice, always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: March 21, 2022
Read our methodology - how this data is sourced, computed, and verified.
Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled and last refreshed May 2026. See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a correction.
All federal data sources used on this page
- FDA Orange Book - approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed - NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) - post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm - standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files - federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database - current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages