What Is Rivastigmine? Uses, Dosage, and What You Need to Know in 2026

Rivastigmine is a prescription medication used to manage symptoms of dementia in people with Alzheimer's disease and Parkinson's disease. If you or a family member has just been prescribed rivastigmine — or you're researching it before an appointment — this guide will tell you everything you need to know in plain language.

What Is Rivastigmine Used For?

Rivastigmine is FDA-approved for:

Mild to moderate Alzheimer's disease dementia (oral capsule and patch)

Mild, moderate, and severe Alzheimer's disease dementia (13.3 mg/24h patch only)

Mild to moderate Parkinson's disease dementia (oral capsule and patch) — the only FDA-approved treatment for this specific indication

It is sold under the brand name Exelon (capsule brand discontinued; Exelon Patch still available). The generic form, rivastigmine, is more commonly used today.

Rivastigmine does not cure Alzheimer's or Parkinson's disease, and it does not stop these diseases from progressing. However, it can temporarily improve memory, thinking, and the ability to perform daily tasks for some patients — allowing them to remain more independent for longer.

What Forms Does Rivastigmine Come In?

Rivastigmine is available in three forms:

Oral capsules: 1.5 mg, 3 mg, 4.5 mg, and 6 mg strengths. Taken twice daily with morning and evening meals.

Oral solution: 2 mg per mL. Useful for patients who have difficulty swallowing capsules. Can be mixed with water, juice, or soda.

Transdermal patch: 4.6 mg/24h, 9.5 mg/24h, and 13.3 mg/24h. Applied once daily to skin on the back, upper arm, or chest. Change every 24 hours.

How Is Rivastigmine Dosed?

Rivastigmine always starts at a low dose and is gradually increased — this is called titration — to reduce the chance of side effects, especially nausea and vomiting.

Oral capsule dosing (Alzheimer's or Parkinson's dementia):

Start: 1.5 mg twice daily (3 mg/day total)

Increase by 1.5 mg twice daily every 2 weeks if tolerated (Alzheimer's) or every 4 weeks (Parkinson's)

Maximum dose: 6 mg twice daily (12 mg/day total)

Transdermal patch dosing:

Start: 4.6 mg/24h patch

After at least 4 weeks: increase to 9.5 mg/24h (standard maintenance)

For Alzheimer's: can further increase to 13.3 mg/24h after another 4+ weeks

Maximum dose: 13.3 mg/24h

How to Take Rivastigmine Correctly

For the oral capsule or solution:

Always take with food (morning and evening meals) to reduce nausea

Swallow capsules whole — do not crush or chew

If you miss a dose, take it as soon as you remember — but skip it if it's almost time for the next dose. Never double up.

If several doses have been missed, call your doctor before restarting

For the transdermal patch:

Apply to clean, dry, hairless skin on the back, upper arm, or chest

Change every 24 hours — remove the old patch before applying a new one

Rotate the site daily to prevent skin irritation

Never wear two patches at once — this is a dangerous medication error

Protect the patch from direct heat sources (heating pads, saunas, hot tubs) — heat increases absorption

Is Rivastigmine a Controlled Substance?

No. Rivastigmine is not a controlled substance and is not scheduled by the DEA. It can be prescribed by any licensed provider with prescribing authority, refilled multiple times on a single prescription (per your state's laws), and prescribed via telehealth for established patients.

Next Steps

For a deeper explanation of how rivastigmine works in the brain, see our guide to rivastigmine's mechanism of action. If you're having trouble finding rivastigmine at your pharmacy, medfinder can help locate it near you.