Rivastigmine Adverse Effects: Complete Heart Block

Xixi Amley, MD, Lou Mastrine, DO, Jason Esses, MD, Gerald Hollander, MD


Context: Rivastigmine (Exelon), a brain selective cholinesterase inhibitor, is used in the treatment of Alzheimer’s Disease (AD) to improve cognitive functions.

Case Report: We report a case in which the addition of rivastigmine to memantine and metoprolol resulted in complete heart block and possibly predisposing a patient to syncope.

Conclusion: Rivastigmine should be used with caution, especially in patients with such structural heart diseases as aortic stenosis and those taking other medications that may contribute to bradycardia.

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