RASTOMINE

*Mild to moderate dementia in Alzheimers disease:* ORAL: Adult: Initially 1.5 mg twice daily, increased in steps of 1.5 mg twice daily, at intervals of at least 2 weeks according to response and tolerance; usual dose 3-6 mg twice daily (max. per dose 6 mg twice daily), if treatment interrupted for several days, retitrate from 1.5mg twice daily. BY TRANSDERMAL PATCHES: Adult: Apply 4.6 mg/24 hours daily for at least 4 weeks, increased if tolerated to 9.5 mg/24 hours daily for a further 6 months, then increased if necessary to 13.3 mg/24 hours daily, increase to 13.3 mg/24 hours patch if well tolerated and cognitive deterioration or functional decline demonstrated; use caution in patients with body-weight less than 50 kg, if treatment interrupted for more than 3 days, retitrate from4.6 mg/24 hours patch. *Mild to moderate dementia in Parkinsons disease:* ORAL: Adult: Initially 1.5 mg twice daily, increased in steps of1.5 mg twice daily, dose to be increased at intervals of at least 2 weeks according to response and tolerance; usual dose 3-6 mg twice daily (max. per dose 6 mg twice daily), if treatment interrupted for several days, retitrate from 1.5mg twice daily.

Hepatic or renal impairment, sick sinus syndrome, conduction defects, history or risk of GI ulceration, asthma, obstructive pulmonary disease, bladder outflow obstruction. Monitor weight loss.

Depolarising neuromuscular blockers, cholinergic and anticholinergic agents.

Agitation, bradycardia, drowsiness, depression, anorexia, anxiety, confusion, diarrhoea, dizziness, dyspepsia, extrapyramidal symptoms, headache, increased salivation, insomnia, malaise, nausea, sweating, tremor, urinary incontinence, vomiting, weight loss, aggression, dehydration, hepatitis, restlessness, sick sinus syndrome, skin hypersensitivity reactions. Rare: Atrial fibrillation, AV block, angina, duodenal ulceration, gastric ulceration, rash, seizures, syncope