Exelon patch overdose

Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy. Rivastigmine falls into category B. There are no well-done studies that have been done in humans with rivastigmine.

But in animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication. It is not known if rivastigmine crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication.

Your doctor and you will decide if the benefits outweigh the risk of using rivastigmine. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you. If you have taken too much rivastigmine more than the prescribed amount call your local Poison Control Center or seek emergency medical attention right away. Rivastigmine treats dementia in people with Alzheimer's or Parkinsons disease. Rivastigmine Overview Updated: March 25, This medication comes in capsule, and oral solution liquid forms.

It is usually taken twice a day with meals. Rivastigmine is also available as a patch to be applied to the skin once daily. Common side effects include nausea, vomiting, loss of appetite, and dizziness.

How was your experience with Rivastigmine? First, a little about yourself Male Female. What tips would you provide a friend before taking Rivastigmine?

Choose one. Back Next. How well did Rivastigmine work for you? Did you experience many side effects while taking this drug? How likely would you be to recommend Rivastigmine to a friend? Back Submit. Rivastigmine Cautionary Labels Back to Top. Uses of Rivastigmine Back to Top. This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. Rivastigmine Brand Names Back to Top. Rivastigmine may be found in some form under the following brand names: Exelon.

Rivastigmine Drug Class Back to Top. Rivastigmine is part of the drug class: Anticholinesterases. Side Effects of Rivastigmine Back to Top. Rivastigmine may cause serious side effects. See "Drug Precautions" section. The most common side effects of rivastigmine include:. Rivastigmine Interactions Back to Top.

Be sure to mention any of the following: antihistamines aspirin and other nonsteroidal anti-inflammatory medications NSAIDs such as ibuprofen Advil, Motrin and naproxen Aleve , Naprosyn bethanechol Duvoid, Urabeth, Urecholine ipratropium Atrovent medicines for Alzheimer's disease glaucoma medicines medicines for irritable bowel disease, motion sickness, myasthenia gravis, Parkinson's disease, ulcers, or urinary problems.

Rivastigmine Precautions Back to Top. Rivastigmine may cause serious side effects including: stomach or bowel intestinal problems, including: nausea vomiting diarrhea loss of appetite weight loss bleeding in your stomach ulcers heart problems seizures problems with movement tremors Skin reactions.

Some people have had a serious skin reaction called allergic contact dermatitis ACD when using rivastigmine patch. Stop using rivastigmine patch and call your healthcare provider right away if you experience reactions that spread beyond the patch size, are intense in nature and do not improve within 48 hours after the patch is removed.

Symptoms of ACD may be intense and include: itching, redness, swelling, warmth or tenderness of the skin peeling or blistering of the skin that may ooze, drain or crust over Do not take rivastigmine if you are allergic to any of the ingredients rivastigmine.

Rivastigmine Food Interactions Back to Top. Inform MD Back to Top. Before taking rivastigmine: tell your doctor and pharmacist if you are allergic to rivastigmine, neostigmine Prostigmin , physostigmine Antilirium, Isopto Eserine , pyridostigmine Mestinon, Regonol , any other medications, or any of the ingredients in rivastigmine solution.

Ask your pharmacist for a list of the ingredients. Be sure to mention any of the following: antihistamines; aspirin and other nonsteroidal anti-inflammatory medications NSAIDs such as ibuprofen Advil, Motrin and naproxen Aleve , Naprosyn ; bethanechol Duvoid, Urabeth, Urecholine ; ipratropium Atrovent ; and medications for Alzheimer's disease, glaucoma, irritable bowel disease, motion sickness, myasthenia gravis, Parkinson's disease, ulcers, or urinary problems.

If you become pregnant while taking rivastigmine, call your doctor. Also, local anesthetics interfere with the release of acetylcholine. Dosage adjustment of the cholinesterase inhibitor may be necessary. Aspirin, ASA; Caffeine; Orphenadrine: Moderate Concurrent use of certain muscle relaxants, such as cyclobenzaprine or orphenadrine, with rivastigmine should be avoided if possible.

Use of cyclobenzaprine or high doses of orphenadrine may result in significant anticholinergic activity, thereby interfering with the therapeutic effect of rivastigmine. Atenolol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope.

Atenolol; Chlorthalidone: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope. Atracurium: Moderate A higher atracurium dose may be required to achieve neuromuscular block with concomitant use of a cholinesterase inhibitor, such as rivastigmine. Atropine: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Atropine; Difenoxin: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Atropine; Edrophonium: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity. Belladonna Alkaloids; Ergotamine; Phenobarbital: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Belladonna; Opium: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity. Bendroflumethiazide; Nadolol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope.

Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Benztropine: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity. Beta-blockers: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope.

Betaxolol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope. Bisoprolol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope. Bisoprolol; Hydrochlorothiazide, HCTZ: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope.

Brimonidine; Timolol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope. Brompheniramine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Brompheniramine; Carbetapentane; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Brompheniramine; Dextromethorphan; Guaifenesin: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Brompheniramine; Dextromethorphan; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Brompheniramine; Guaifenesin; Hydrocodone: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Brompheniramine; Hydrocodone; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Brompheniramine; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Brompheniramine; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Brompheniramine; Pseudoephedrine; Dextromethorphan: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Budesonide; Glycopyrrolate; Formoterol: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity. Bupivacaine Liposomal: Moderate Local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used.

Bupivacaine: Moderate Local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used. Bupivacaine; Epinephrine: Moderate Local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used.

Bupivacaine; Lidocaine: Moderate Local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used. Moderate Local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used; dosage adjustments of the cholinesterase inhibitor may be necessary.

In addition, inhibitors of CYP1A2, such as tacrine, could theoretically reduce lidocaine metabolism and increase the risk of toxicity when given concurrently. Also, rivastigmine is an acetylcholinesterase inhibitor and therefore is likely to exaggerate muscle relaxation under general anesthetics. Bupivacaine; Meloxicam: Moderate Local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used.

Carbetapentane; Chlorpheniramine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Carbetapentane; Chlorpheniramine; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Carbetapentane; Diphenhydramine; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Carbetapentane; Phenylephrine; Pyrilamine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Carbetapentane; Pyrilamine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Carbinoxamine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Carbinoxamine; Dextromethorphan; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Carbinoxamine; Hydrocodone; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Carbinoxamine; Hydrocodone; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Carbinoxamine; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Carbinoxamine; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Carteolol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope. Carvedilol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope.

Chlophedianol; Dexbrompheniramine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlophedianol; Dexchlorpheniramine; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Chlorcyclizine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlordiazepoxide; Clidinium: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity. Chloroprocaine: Moderate Local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used.

Chlorpheniramine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlorpheniramine; Codeine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlorpheniramine; Dextromethorphan: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Chlorpheniramine; Dextromethorphan; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlorpheniramine; Dextromethorphan; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlorpheniramine; Dihydrocodeine; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlorpheniramine; Dihydrocodeine; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlorpheniramine; Hydrocodone: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlorpheniramine; Hydrocodone; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlorpheniramine; Hydrocodone; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Chlorpheniramine; Ibuprofen; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlorpheniramine; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Chlorpheniramine; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Chlorpromazine: Moderate Conventional antipsychotics with significant anticholinergic effects, such as chlorpromazine, are more likely than other conventional antipsychotics to diminish the therapeutic action of rivastigmine, and use of an alternative antipsychotic should be considered.

Rivastigmine inhibits acetylcholinesterase, the enzyme responsible for the degradation of acetylcholine, and exerts its therapeutic effect by improving the availability of acetylcholine.

Consider the use of an antipsychotic with less prominent anticholinergic effects. Cholinergic agonists: Major Cholinergic agonists can cause additive pharmacodynamic effects if used concomitantly with cholinesterase inhibitors. Concurrent use is unlikely to be tolerated by the patient and should be avoided.

Cisatracurium: Moderate A higher cisatracurium dose may be required to achieve neuromuscular block with concomitant use of a cholinesterase inhibitor, such as rivastigmine. Clemastine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Clozapine: Moderate Concurrent use of rivastigmine and clozapine should be avoided if possible.

Clozapine exhibits considerable anticholinergic activity, and is more likely than other atypical antipsychotics to diminish the therapeutic action of rivastigmine. Cocaine: Major cholinesterase inhibitors reduce the metabolism of cocaine, therefore, prolonging cocaine's effects or increasing the risk of toxicity.

It should be taken into consideration that the cholinesterase inhibition caused by echothiophate, demecarium, or isoflurophate may persist for weeks or months after the medication has been discontinued. Additionally, local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used.

Dosage adjustment of the cholinesterase inhibitor may be necessary to control the symptoms of myasthenia gravis. Codeine; Phenylephrine; Promethazine: Moderate Promethazine exhibits anticholinergic properties that could potentially interfere with the cholinesterase inhibitor activity of rivastigmine. When concurrent use cannot be avoided, monitor the patient for reduced rivastigmine efficacy. Codeine; Promethazine: Moderate Promethazine exhibits anticholinergic properties that could potentially interfere with the cholinesterase inhibitor activity of rivastigmine.

Cyclizine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Cyclobenzaprine: Moderate Concurrent use of certain muscle relaxants, such as cyclobenzaprine or orphenadrine, with rivastigmine should be avoided if possible.

Cyproheptadine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Dexbrompheniramine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Dexbrompheniramine; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Dexchlorpheniramine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Dextromethorphan; Diphenhydramine; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Dicyclomine: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity. Digoxin: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope.

The vagotonic effect of these drugs may be increased when given with other medications known to cause bradycardia such as digoxin. Dimenhydrinate: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Diphenhydramine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Diphenhydramine; Hydrocodone; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Diphenhydramine; Ibuprofen: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Diphenhydramine; Naproxen: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Diphenhydramine; Phenylephrine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Diphenoxylate; Atropine: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Disopyramide: Moderate Concurrent use of disopyramide and rivastigmine should be avoided if possible. Disopyramide may exhibit significant anticholinergic activity, thereby interfering with the therapeutic effect of rivastigmine. Dorzolamide; Timolol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope.

Doxylamine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Doxylamine; Pyridoxine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible. Esmolol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope.

Etomidate: Moderate Muscle relaxation produced by succinylcholine can be prolonged when the drug is administered with a cholinesterase inhibitor. Other neuromuscular blockers may interact with cholinesterase inhibitors in a similar fashion. Cholinesterase inhibitors are therefore also likely to exaggerate muscle relaxation under general anesthetics. Flavoxate: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Fospropofol: Moderate Muscle relaxation produced by succinylcholine can be prolonged when the drug is administered with a cholinesterase inhibitor. Glycopyrrolate: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Glycopyrrolate; Formoterol: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Halogenated Anesthetics: Moderate Muscle relaxation produced by succinylcholine can be prolonged when the drug is administered with a cholinesterase inhibitor.

Homatropine; Hydrocodone: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity. Hydroxyzine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Hyoscyamine: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity. Indacaterol; Glycopyrrolate: Moderate The therapeutic benefits of rivastigmine, a cholinesterase inhibitor, may be diminished during chronic co-administration with antimuscarinics or medications with potent anticholinergic activity.

Ketamine: Moderate Muscle relaxation produced by succinylcholine can be prolonged when the drug is administered with a cholinesterase inhibitor. Labetalol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope.

Levobetaxolol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope. Levobunolol: Moderate The increase in vagal tone induced by some cholinesterase inhibitors may produce bradycardia, hypotension, or syncope. Levobupivacaine: Moderate Local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used.

Lidocaine: Moderate Local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used; dosage adjustments of the cholinesterase inhibitor may be necessary.

Lidocaine; Prilocaine: Moderate Local anesthetics can antagonize the effects of cholinesterase inhibitors by inhibiting neuronal transmission in skeletal muscle, especially if large doses of local anesthetics are used. Maprotiline: Moderate Concurrent use of maprotiline and rivastigmine should be avoided if possible. Maprotiline may exhibit significant anticholinergic activity, thereby interfering with the therapeutic effect of rivastigmine. Meclizine: Moderate Concurrent use of sedating H1-blockers and rivastigmine should be avoided if possible.

Print Friendly. Severe gastrointestinal GI adverse reactions to the rivastigmine patch The rivastigmine patch, when given in higher-than-recommended doses, is associated with significant GI adverse reactions, including nausea, vomiting, diarrhea, decreased appetite and weight loss.

The rivastigmine patch is minimally effective A single major trial was used by the FDA as the basis for approval of the rivastigmine patch. Application to the same skin location within 14 days should be avoided to minimize skin irritation.

The patch should not be cut into pieces. Enjoying our content? You are currently viewing a snippet of one of our drug reviews or articles. Subscribe in order to get full access to all our content, or login if you are already a subscriber. Subscriptions Subscribe to WorstPills.