Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-29T01:28:28.085Z Has data issue: false hasContentIssue false
  • English
  • Français

Rivastigmine and Concomitant Memantine in Alzheimer's Disease: Safety and Tolerability

Published online by Cambridge University Press:  07 November 2014

Beth Safirstein ,
Xiangyi Meng  and
Jason T. Olin
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Investigate the safety and tolerability of rivastigmine capsules and transdermal patch in patients with moderate Alzheimer's disease receiving concomitant memantine.

Methods: Safety data from two prospective, open-label, multicenter trials were analyzed. Study US32: patients received rivastigmine capsules (3–12 mg/day) plus memantine (20 mg/day). Study US38: patients switched from donepezil to rivastigmine patches (4.6 mg/24 hours) immediately or following 7 days' withdrawal; ∼50% received concomitant memantine (20 mg/day).

Results: The rivastigmine patch demonstrated more favorable tolerability than rivastigmine capsules, being associated with fewer adverse events (AEs) (73% versus 83%), serious AEs (10% versus 23%) and gastrointestinal symptoms (4% versus 26% for nausea; 4% versus 11% for vomiting). Application site reactions occurred in 17% of patients.

Conclusion: Concomitant memantine treatment with rivastigmine patch and capsule is generally well tolerated. The favorable tolerability and safety profile of rivastigmine transdermal patch is not further improved with concomitant memantine. Recommendations to minimize application site reactions are provided.

Type
Original Research
Information
CNS Spectrums , Volume 15 , Issue 9 , September 2010 , pp. 594 - 598
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Exelon Capsule. Prescribing Information. Available at: http://www.pharma.us.novartis.com/product/pi/pdf/exelon.pdf. 2001. Accessed: August 2010.Google Scholar
2.Rösler, M, Anand, R, Cicin-Sain, A, et al. Efficacy and safety of rivastigmine in patients with Alzheimer's disease: international randomised controlled trial. BMJ. 1999; 318 (7184): 633–638.CrossRefGoogle ScholarPubMed
3.Olin, J, Bhatnagar, V, Reyes, P, Koumaras, B, Meng, X, Brannan, S. Safety and tolerability of rivastigmine capsules with memantine in patients with probable Alzheimer's disease: a 26-week, open-label, prospective trial. Int J Geriatr Psychiatry. 2010; 25(4): 419–426.CrossRefGoogle ScholarPubMed
4. Exelon transdermal patch. Prescribing information. Available at: http://www.pharma.us.novartis.com/product/pi/pdf/exelonpatch.pdf. 2007. Accessed: August 2010.Google Scholar
5.Winblad, B, Grossberg, G, Frolich, L, et al. IDEAL: a 6-month, double-blind, placebo-controlled study of the first skin patch for Alzheimer disease. Neurology. 2007; 69(4 Suppl 1): S14–22.CrossRefGoogle ScholarPubMed
6.Sadowsky, C, Dengiz, A, Olin, J, Koumaras, B, Meng, X, Brannan, S. Switching from donepezil tablets to rivastigmine transdermal patch in Alzheimer's disease. Am J Alzheimer Dis Other Demen. 2009; Epub 16 March:doi: 10.1177/1533317509333037.Google Scholar
7.Folstein, MF, Folstein, SE, McHugh, PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3): 189–198.CrossRefGoogle Scholar
8.Diagnostic and Statistical Manual of Mental Disorders. 4th ed, Text rev. Washington, DC: American Psychiatric Association; 1994.Google Scholar
9.McKhann, G, Drachman, D, Folstein, M, Katzman, R, Price, D, Stadlan, EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984; 34(7): 939–944.CrossRefGoogle ScholarPubMed
10.Winblad, B, Cummings, J, Andreasen, N, et al. A six-month double-blind, randomized, placebo-controlled study of a transdermal patch in Alzheimer's disease--rivastigmine patch versus capsule. Int J Geriatr Psychiatry. 2007; 22(5): 456–467.CrossRefGoogle ScholarPubMed