Rivastigmine (Exelon)


Prevention of Intensive Care Unit-Associated Delirium (see Delirium, [[Delirium]])

  • Clinical Efficacy
    • Randomized Trial of Rivastigmine to Prevent Post-Operative Delirium Following Cardiothoracic Surgery (Crit Care Med, 2009) [MEDLINE]
      • Oral Rivastigmine Did Not Prevent Post-Operative Delirium in Elderly Patients Undergoing Elective Cardiac Surgery with Cardiopulmonary Bypass: study had methodologic issues, which were noted by the authors
    • Dutch Trial of Rivastigmine in Critically Ill Patients >18 y/o with Delirium (Lancet, 2010) [MEDLINE]
      • Rivastigmine Increased the Duration of Delirium and Mortality Rate in Critically Ill Patients (as Compared to Usual Care and Haloperidol)


  • Cholinesterase Inhibitor


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Dose Adjustment

  • Hepatic:
  • Renal:

Adverse Effects

Other Adverse Effects

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  • Rivastigmine for the prevention of postoperative delirium in elderly patients undergoing elective cardiac surgery—a randomized controlled trial. Crit Care Med. 2009;37:1762–1768 [MEDLINE]
  • Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomised trial. Lancet. 2010 Nov 27;376(9755):1829-37. doi: 10.1016/S0140-6736(10)61855-7. Epub 2010 Nov 4 [MEDLINE]