Rivastigmine (Exelon)

Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.

About Rivastigmine

What it is

Rivastigmine is a cholinesterase inhibitor that blocks both acetylcholinesterase and butyrylcholinesterase, so more of the memory messenger acetylcholine stays available. It is used for mild to moderate Alzheimer's dementia and dementia in Parkinson's disease, as capsules or as a skin patch. It is sold as Exelon, among other names.

How genes come into it

Rivastigmine is broken down by the very cholinesterases it blocks, not by liver CYP enzymes, so the usual drug-processing genes play little part. Studies have looked at CHAT, the gene for the enzyme that makes acetylcholine, at BCHE and ACHE, its targets, and at the choline transporter SLC5A7 for how well it slowed decline, with mixed results. There is no CPIC or DPWG guideline.

What research found

Every published finding on gene variants and Rivastigmine. Upload your DNA file to see which of these rows apply to you.

Rated evidence (5 rated variants)

PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.

BCHE rs1803274: Level 3. Efficacy: Alzheimer Disease, Lewy Body Disease. 4.

CHAT rs3793790: Level 3. Efficacy: Alzheimer Disease. 1.

CHRNA7 rs6494223: Level 3. Efficacy: Alzheimer Disease. 1.

CHAT rs2177370: Level 3. Efficacy: Alzheimer Disease. 1.

Response (38 findings)

Studies of how well it worked in people carrying a variant.

rs17798800: Allele T is associated with decreased response to donepezil, galantamine and rivastigmine in people with Alzheimer Disease as compared to allele C.

ACHE rs2571598: Genotype TT is associated with increased response to rivastigmine in people with Alzheimer Disease as compared to genotypes CC + CT.

APOE rs429358: Genotypes CC + CT is associated with decreased response to donepezil, galantamine and rivastigmine in people with Alzheimer Disease as compared to genotype TT.

BCHE rs1803274: Genotype CC is associated with increased response to rivastigmine in people with Alzheimer Disease as compared to genotypes CT + TT.

Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.

Related Drugs

More drugs from the same category

Aricept (Cholinesterase Inhibitors)

Razadyne (Cholinesterase Inhibitors)

Abilify (Antipsychotics)

Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.

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Content updated September 2026.

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