Exelon vs Galantamine: Key Differences and What Works Best for Alzheimer’s

When it comes to treating mild to moderate Alzheimer’s disease, Exelon, a brand name for rivastigmine, is a cholinesterase inhibitor used to slow cognitive decline by increasing acetylcholine levels in the brain. Also known as rivastigmine, it’s available as a patch or capsule and is often chosen for its once-daily dosing convenience. Galantamine, another cholinesterase inhibitor, works similarly but also modulates nicotinic receptors, which may help improve attention and memory more directly. Also called Razadyne, it’s taken orally as a tablet or capsule, usually twice a day. Both drugs are part of the same class — cholinesterase inhibitors, a group of medications designed to boost brain chemicals involved in learning and memory — but they’re not interchangeable. Each has different side effect profiles, dosing schedules, and patient responses.

Exelon’s patch form is a big plus for people who have trouble swallowing pills or forget to take daily meds. It delivers steady drug levels without spikes, which often means fewer stomach issues like nausea. But skin irritation at the patch site is common, and some users find it bulky or embarrassing. Galantamine, on the other hand, doesn’t have a patch option, but many patients report better mental clarity and fewer gastrointestinal problems compared to other cholinesterase inhibitors. It’s also one of the few dementia drugs studied in combination with memantine (Namenda), making it a flexible choice for mid-stage Alzheimer’s.

Neither drug stops Alzheimer’s progression — they just slow it down, often by a few months to a year. But that’s meaningful. For families, the difference between remembering a name or a meal can be huge. Exelon might be better for someone with a busy caregiver who needs a low-maintenance option. Galantamine might suit someone who’s more alert in the morning and can handle twice-daily pills. Both can cause dizziness, fatigue, or diarrhea, so starting low and going slow is key. The choice often comes down to tolerance, lifestyle, and how the person responds over time. There’s no one-size-fits-all answer, which is why doctors often try one before switching to the other.

What you’ll find below are real comparisons from patients and clinicians who’ve used both Exelon and galantamine — not just theory, but what actually happens in daily life. You’ll see how side effects play out over weeks, how caregivers manage dosing, and why some people switch mid-treatment. These aren’t abstract studies. They’re stories from people living with Alzheimer’s and the people who support them. Whether you’re deciding between these two drugs or just trying to understand why your doctor recommended one over the other, this collection gives you the practical details you won’t find in a pamphlet.