Formulary Search

As combination therapy - Appropriate for Primary Care initiation when being added to existing AChE inhibitor therapy in patients with worsening cognitive function or other markers of deterioration.

Reserve orodispersible tablets and oral solution for patients who are unable to swallow tablets.

As monotherapy in patients with severe Alzheimer's or in moderate disease where an AChE is not tolerated.

On recommendation from the mental health specialist team in patients who may or may not require ongoing follow-up from the specialist service.

Reserve oral solution and orodispersible tablets for patients who are unable to swallow tablets.

Suitable for primary care prescribing on recommendation from the mental health specialist team in patients who may or may not require ongoing follow-up from the specialist service.

Reserve oral solution and orodispersible tablets for patients who are unable to swallow tablets.

Suitable for primary care prescribing on recommendation from the mental health specialist team in patients who may or may not require ongoing follow-up from the specialist service.

Reserve oral solution for patients who are unable to swallow capsules.

PATCHES - suitable for primary care prescribing on recommendation from the mental health specialist team in patients who may or may not require ongoing follow-up from the specialist service.

SAFETY WARNING - patches are available as DAILY or TWICE WEEKLY but both are described in mg/24 hours. Care required to ensure that the intended patch is prescribed and dispensed.

An MHRA alert has also been issued in response to rivastigmine overdose due to multiple patch application, cutting patches and application of patches to non-recommended sites: https://www.gov.uk/drug-safety-update/rivastigmine-exelon-transdermal-patch-risk-of-medication-errors?UNLID=7961636092025721172155

This drug has not yet been assessed for formulary status.
If a patient is accessing non-NHS supplies of this medication, refer to the NHSE information here  (for a similar drug called lecanemab) which provides advice on potential adverse effects.

Lecanemab used in Alzheimer’s disease is currently not available in the NHS. Eisai (the manufacturer and market authorisation holder for lecanemab (Leqembi®)) has started to make the drug available for patients to access through independent sector clinics.
 

The information from NHSE here provides advice for clinical teams who may be asked to support referrals for private treatment or otherwise assess, advise and possibly treat a small number of patients who could present with potential adverse treatment effects, including symptomatic Amyloid-Related Imaging Abnormalities (ARIA).