Rivastigmine

Rivastigmine
Clinical data
Trade names	Exelon, others
AHFS/Drugs.com	Monograph
MedlinePlus	a602009
License data	US DailyMed: Rivastigmine;
Pregnancy; category	AU: B2;
Routes of; administration	By mouth, transdermal patch
ATC code	N06DA03 (WHO) ;
Legal status
Legal status	AU: S4 (Prescription only); BR: Class C1 (Other controlled substances); CA: ℞-only; US: ℞-only; EU: Rx-only;
Pharmacokinetic data
Bioavailability	60 to 72%
Protein binding	40%
Metabolism	Liver, via pseudocholinesterase
Elimination half-life	1.5 hours
Excretion	97% in urine
Identifiers
	IUPAC name (S)-3-[1-(dimethylamino)ethyl]phenyl N-ethyl-N-methylcarbamate;
CAS Number	123441-03-2 ;
PubChem CID	77991;
IUPHAR/BPS	6602;
DrugBank	DB00989 ;
ChemSpider	70377 ;
UNII	PKI06M3IW0;
KEGG	D03822 ;
ChEBI	CHEBI:8874 ;
ChEMBL	ChEMBL636 ;
CompTox Dashboard (EPA)	DTXSID7023564 ;
ECHA InfoCard	100.120.679
Chemical and physical data
Formula	C14H22N2O2
Molar mass	250.342 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES O=C(Oc1cc(ccc1)[C@@H](N(C)C)C)N(CC)C;
	InChI InChI=1S/C14H22N2O2/c1-6-16(5)14(17)18-13-9-7-8-12(10-13)11(2)15(3)4/h7-11H,6H2,1-5H3/t11-/m0/s1 ; Key:XSVMFMHYUFZWBK-NSHDSACASA-N ;
	(what is this?) (verify)

Rivastigmine, sold under the brand name Exelon among others, is an acetylcholinesterase inhibitor used for the treatment of dementia associated with Alzheimer's disease and with Parkinson's disease.^[4]^[6]^[7] Rivastigmine can be administered orally or via a transdermal patch; the latter form reduces the prevalence of side effects,^[8] which typically include nausea and vomiting.^[9]

Rivastigmine is eliminated through the urine, and appears to have relatively few drug-drug interactions.^[9]

It was patented in 1985 and came into medical use in 1997.^[10]

^ "Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017". Therapeutic Goods Administration (TGA). 21 June 2022. Archived from the original on 6 July 2023. Retrieved 30 March 2024.
^ "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control]. Diário Oficial da União (in Brazilian Portuguese). Agência Nacional de Vigilância Sanitária (published 4 April 2023). 31 March 2023. Archived from the original on 3 August 2023. Retrieved 16 August 2023.
^ "Product monograph brand safety updates". Health Canada. 7 July 2016. Archived from the original on 29 March 2024. Retrieved 1 April 2024.
^ ^a ^b "Exelon- rivastigmine patch, extended release". DailyMed. 8 May 2024. Retrieved 16 August 2024.
^ "Prometax EPAR". European Medicines Agency (EMA). 4 December 1998. Archived from the original on 22 June 2021. Retrieved 16 August 2024.
^ Khoury R, Rajamanickam J, Grossberg GT (March 2018). "An update on the safety of current therapies for Alzheimer's disease: focus on rivastigmine". Therapeutic Advances in Drug Safety. 9 (3). SAGE Publications: 171–178. doi:10.1177/2042098617750555. PMC 5810854. PMID 29492246.
^ Tanner CM, Ostrem JL (August 2024). "Parkinson's Disease". The New England Journal of Medicine. 391 (5): 442–452. doi:10.1056/NEJMra2401857. PMID 39083773.
^ Cite error: The named reference Winblad was invoked but never defined (see the help page).
^ ^a ^b Cite error: The named reference Inglis was invoked but never defined (see the help page).
^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 540. ISBN 9783527607495. Archived from the original on 11 January 2023. Retrieved 2 June 2020.

[1] "Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017". Therapeutic Goods Administration (TGA). 21 June 2022. Archived from the original on 6 July 2023. Retrieved 30 March 2024.

[2] "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control]. Diário Oficial da União (in Brazilian Portuguese). Agência Nacional de Vigilância Sanitária (published 4 April 2023). 31 March 2023. Archived from the original on 3 August 2023. Retrieved 16 August 2023.

[3] "Product monograph brand safety updates". Health Canada. 7 July 2016. Archived from the original on 29 March 2024. Retrieved 1 April 2024.

[Exelon_FDA_label-4] "Exelon- rivastigmine patch, extended release". DailyMed. 8 May 2024. Retrieved 16 August 2024.

[Prometax_EPAR-5] "Prometax EPAR". European Medicines Agency (EMA). 4 December 1998. Archived from the original on 22 June 2021. Retrieved 16 August 2024.

[Khoury_Rajamanickam_Grossberg_2018_pp._171–178-6] Khoury R, Rajamanickam J, Grossberg GT (March 2018). "An update on the safety of current therapies for Alzheimer's disease: focus on rivastigmine". Therapeutic Advances in Drug Safety. 9 (3). SAGE Publications: 171–178. doi:10.1177/2042098617750555. PMC 5810854. PMID 29492246.

[Tanner_2024-7] Tanner CM, Ostrem JL (August 2024). "Parkinson's Disease". The New England Journal of Medicine. 391 (5): 442–452. doi:10.1056/NEJMra2401857. PMID 39083773.

[Winblad-8] Cite error: The named reference Winblad was invoked but never defined (see the help page).

[Inglis-9] Cite error: The named reference Inglis was invoked but never defined (see the help page).

[Fis2006-10] Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 540. ISBN 9783527607495. Archived from the original on 11 January 2023. Retrieved 2 June 2020.

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