Reduce side effects of Alzheimer's drugs

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• Sun Pharma gets USFDA approval to market Exelon^® capsules, IRIS. 23 October, 2007.
• Feldman, H.H., Lane R.: Study 304 Group, Rivastigimine  a placebo controlled trial of twice daily and three times daily regimens in patients with Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry. 2007 October; 78(10):1056-63. Epub 2007 Mar 12.

Learn the best ways to dose Alzheimer's medications. See how anti-dementia drugs like Exelon^®(rivastigmine) help treat Alzheimer's symptoms. 

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An important study shows anti-Alzheimer's capsulesare better tolerated when spread out over a three-times-a-day regimen. Similarly, anti-Alzheimer's skin-patches can lower side-effects by slowly releasing medication throughout the day. 

The study used the dementia drug known by the brand-name Exelon^®, or generically as rivastigmine. Exelon is an "acetylcholinesterase inhibitor", as are Aricept (donepezil) and Razadyne (galantamine). They all treat dementias such as Alzheimer's in very similar ways. They also share similar side-effects. 

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Exelon^® (rivastigmine) is one of the most common medications prescribed for people with mild to moderate Alzheimer's disease.

Alzheimer's disease is caused by degeneration of the nerve cells that produce acetylcholine. Because of this, preventing loss of this chemical by taking Exelon^® may improve a person's memory, the ability to express himself, understand where he or she is, and to carry out his daily living activities.

Exelon^® slows down Alzheimer’s cognitive decline by preventing the loss of a brain chemical called acetylcholine. Acetylcholine is important for memory and learning.

These 3 Alzheimer's drugs are similar, working as Acetylcholinesterase Inhibitors:
Brand Name	Generic
Exelon	rivastigmine
Aricept	donepezil
Razadyne	galantamine

It has been more than 10 years since Exelon^® first came out on the market. It is now used to treat Alzheimer's disease in more than 70 countries around the world. It is approved by the Food and Drug Administration (FDA) for treatment of Alzheimer's and Parkinson's disease dementia in the United States as well as by the European Commission in Europe.

There are several different forms of Exelon^® and a number of different doses, making it easier and safer to take, including gel capsules, liquid and through a skin patch.

As mentioned, a study published in the Journal of Neurology, Neurosurgery and Psychiatry found that Exelon^® capsules were best tolerated when prescribed in a three-times-a-day regimen, instead of twice a day. According to the principle investigator, Dr. Howard H. Feldman, the overall daily dose remained the same, but was divided into three smaller doses, distributed evenly throughout the day. This reduced side effects because the dosage-spike was lower when the level of medication swallowed at one time was lower.

For people who can't swallow pills, Exelon^® is available in liquid form. Many elderly people have trouble swallowing pills and they often fight with caregivers over having to take the medication as a result. Liquid is less threatening.

Exelon^® is also available in a skin patch, which makes it easier on the patient and the caregiver because it eliminates the need to make sure the liquid or pills are swallowed on time, three times a day. Instead, the medication is absorbed directly from the patch through the skin and into the bloodstream, where it is supplied continually for 24 hours. It only needs to be changed at the beginning of each day, which is a great convenience.

An even more important advantage is in the patch providing a visual reassurance for the caregiver and patient that the patient is receiving their medication.

Exelon^® is also available as generic rivastigmine. Typically, the generic is cheaper than the brand name, Exelon^®, while being the same medication. This is especially important for the elderly, where income often becomes more limited.

One producer of generic rivastigmine capsules is Sun Pharmaceutical Industries, a specialty pharmaceutical company located in India which distributes advanced generic medicines in the United States. Their generic version of Exelon^® come in four strengths: 1.5 mg, 3 mg, 4.5 mg and 6 mg.