Drug interactions
Galantamine + Rivastigmine
Severity: Major
Galantamine and Rivastigmine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both are cholinesterase inhibitors, so using them together duplicates therapy and increases cholinergic toxicity without added benefit. Nausea, vomiting, diarrhea, bradycardia and syncope are more likely.
What this interaction means in plain words
Galantamine and Rivastigmine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Galantamine belongs to Central Nervous System; Rivastigmine belongs to Central Nervous System.
Why it happens
Duplicate acetylcholinesterase inhibition leading to additive cholinergic effects.
What to do
Avoid concurrent use and use only one cholinesterase inhibitor. When switching, stop one and start the other at its initial dose.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Rivastigmine
Other interactions of Galantamine
- Galantamine + Memantine-donepezil Major
- Galantamine + Physostigmine Major
- Galantamine + Ponesimod Major
- Amifampridine + Galantamine Moderate
- Amiodarone + Galantamine Moderate
- Amitriptyline + Galantamine Moderate
Frequently asked questions
Can I take Galantamine with Rivastigmine?
MediHelp rates the interaction as major. Galantamine and Rivastigmine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both are cholinesterase inhibitors, so using them together duplicates therapy and increases cholinergic toxicity without added benefit. Nausea, vomiting, diarrhea, bradycardia and syncope are more likely.
How serious is the interaction between Galantamine and Rivastigmine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use and use only one cholinesterase inhibitor. When switching, stop one and start the other at its initial dose.
What other medicines interact with Rivastigmine?
MediHelp also lists interactions of Rivastigmine with, for example, Donepezil, Memantine-donepezil, Metoclopramide. The full list is on the Rivastigmine page.
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