Dementa-XR
Generic Name
Rivastigmine extended-release 14 mg capsule
Manufacturer
Acme Pharmaceuticals
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dementa xr 14 mg capsule | ৳ 20.00 | ৳ 160.00 |
Description
Overview of the medicine
Dementa-XR 14 mg capsule contains rivastigmine, an acetylcholinesterase inhibitor, used to treat mild to moderate dementia in patients with Alzheimer's disease or Parkinson's disease.
Uses & Indications
Dosage
Adults
Initial dose is typically 4.5 mg once daily for XR. Doses are gradually increased based on tolerability and efficacy, typically by 4.5 mg once daily every 2 weeks. The maximum recommended daily dose for XR is 13.3 mg or 14 mg once daily.
Elderly
No specific dose adjustment generally required based solely on age, but dose titration should be done carefully, considering potential for increased sensitivity to cholinergic effects.
Renal_impairment
No dose adjustment is required for mild to moderate renal impairment. For severe renal impairment, titration should be done carefully.
How to Take
Taken orally once daily with breakfast or the largest meal of the day to minimize gastrointestinal side effects. Swallow the capsule whole; do not chew, crush, or open.
Mechanism of Action
Rivastigmine reversibly inhibits acetylcholinesterase and butyrylcholinesterase, enzymes that degrade acetylcholine. This increases acetylcholine concentrations in the synaptic cleft, enhancing cholinergic neurotransmission and thereby improving cognitive function.
Pharmacokinetics
Onset
Gradual onset of action due to extended-release formulation and titratable dosing. Cognitive effects become apparent over weeks of treatment.
Excretion
Primarily via the kidneys, with approximately 90% of the dose excreted in the urine within 24 hours, mainly as metabolites.
Half life
Plasma half-life is approximately 3.4 hours for the parent drug, but the duration of acetylcholinesterase inhibition is significantly longer (up to 9 hours).
Absorption
Slowly and extensively absorbed after oral administration of the extended-release capsule. Peak plasma concentrations are reached in approximately 8 hours.
Metabolism
Primarily metabolized via cholinesterase-mediated hydrolysis, rather than cytochrome P450 enzymes, reducing drug-drug interaction potential.
Side Effects
Contraindications
- •Hypersensitivity to rivastigmine, other carbamate derivatives, or any component of the formulation.
- •Previous history of severe adverse reactions with rivastigmine transdermal patch leading to discontinuation.
Drug Interactions
Cholinergic drugs (e.g., bethanechol)
May have additive cholinergic effects, increasing the risk of side effects like nausea, vomiting, and bradycardia.
Anticholinergic drugs (e.g., atropine)
Rivastigmine may interfere with the activity of anticholinergic medications.
Succinylcholine-type neuromuscular blockers
May prolong the neuromuscular blockade during anesthesia.
Beta-blockers (e.g., carvedilol, propranolol)
May increase the risk of bradycardia and syncope, especially in patients with pre-existing cardiac conditions.
NSAIDs (Nonsteroidal anti-inflammatory drugs)
Increased risk of gastric ulceration in patients taking NSAIDs concurrently, especially with high doses of rivastigmine.
Storage
Store below 30°C, in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe nausea, vomiting, diarrhea, sweating, bradycardia, hypotension, collapse, and convulsions. A cholinergic crisis with muscle weakness, severe bradycardia, and bronchospasm may occur. Treatment involves general supportive measures and atropine for severe cholinergic symptoms.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether rivastigmine is excreted in human milk. Exercise caution when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months.
Availability
Pharmacies worldwide
Approval Status
Approved by major regulatory bodies
Patent Status
Original patent expired, generic versions available
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