Safety and tolerability of transdermal and oral rivastigmine in Alzheimer's
disease and Parkinson's disease dementia.
Author(s): Darreh-Shori T, Jelic V.
Affiliation(s): Karolinska University Hospital, Karolinska Institute, Department of Neurobiology,
Care Sciences and Society, Division of Alzheimer Neurobiology, Novum, 4th Floor,
Room 4F23:10, 141 86, Huddinge, Stockholm, Sweden. taher.darreh-shori@ki.se
Publication date & source: 2010, Expert Opin Drug Saf. , 9(1):167-76
IMPORTANCE OF THE FIELD: Cholinesterase inhibitors are the mainstay of
symptomatic therapy for Alzheimer's disease (AD). Rivastigmine, an inhibitor of
both acetylcholinesterase and butyrylcholinesterase, is available as a
transdermal patch and in oral forms. It is also approved for the treatment of
Parkinson's disease dementia (PDD) in many countries. The objective of this
article is to review the safety and tolerability profile of transdermal and oral
rivastigmine in AD and PDD patients.
AREAS COVERED IN THIS REVIEW: Articles were identified by searching MEDLINE in
July 2009 using the terms rivastigmine, Exelon, ENA 713 and clinical trial. All
double-blind, placebo-controlled randomized trials in which rivastigmine
monotherapy was administered to AD or PDD patients for longer than 2 weeks were
included.
WHAT THE READER WILL GAIN: This article provides a comprehensive summary of
currently available safety data on rivastigmine.
TAKE HOME MESSAGE: The main adverse events reported with rivastigmine therapy are
gastrointestinal in nature. However, the transdermal patch appears to reduce
these side effects, allowing more patients to access higher therapeutic doses.
Overall, the safety profile of rivastigmine is favorable and the improved
tolerability offered by the rivastigmine patch suggests that transdermal delivery
may be the best way to deliver this drug in AD and PDD patients.
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