Patients w/ severe Alzheimer's dementia, other types of dementia or other types of memory impairment (eg, age-related cognitive decline). May exaggerate succinylcholine-type muscle relaxation during anesth. Potential for vagonotic effects on heart rate (eg, bradycardia) in patients w/ sick sinus syndrome or other supraventricular cardiac conduction conditions eg, SA or AV block. Syncope & seizures. Increased risk for developing ulcers eg, history of ulcer disease or concurrent use of NSAIDs. May cause bladder outflow obstruction. Generalised convulsions; may exacerbate or induce extrapyramidal symptoms. Discontinue treatment if patient develops signs & symptoms indicative of NMS, or presents w/ unexplained high fever w/o additional clinical manifestations of NMS. History of asthma or obstructive pulmonary disease. Avoid concomitant administration w/ other acetylcholinesterase inhibitors, agonist or antagonists of the cholinergic system. Patients w/ galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine. Pregnancy. Not to be used during lactation. Not recommended for use in childn & adolescents <18 yr.
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