Lack of adverse pharmacodynamic drug interactions with rivastigmine and twenty-two classes of medications.
Alzheimer's disease (AD) is often associated with multiple comorbidities and subsequent polypharmacy. Treatment of AD with acetylcholinesterase (AChE) inhibitors can carry a risk of drug interaction with multiple medications often prescribed for other co-existing illnesses. Rivastigmine is an AChE inhibitor that is enzymatically cleaved by AChE, minimally metabolized by cytochrome P450 enzymes, has low protein binding, has a short plasma half-life, and a relatively short duration of action. Such properties make it ideal for use in this patient population. A pharmacodynamic analysis of rivastigmine administered concomitantly with other medications (22 different therapeutic classes) did not reveal any significant pattern of increase in adverse events that would indicate a drug interaction. In summary, rivastigmine was well tolerated and safely administered to a population receiving multiple medications for 'real-world' comorbidities.
Grossberg
G T
GT
St Louis University Medical Center, 1221 S. Grand Blvd, St Louis, MO 63104, USA.
Stahelin
H B
HB
Messina
J C
JC
Anand
R
R
Veach
J
J
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000453:epidemiology; D002219:Carbamates / Q000494:pharmacology* / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D015897:Comorbidity; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D003627:Data Interpretation, Statistical; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D048448:Phenylcarbamates; D019338:Polypharmacy; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D000068836:Rivastigmine
D002219:Carbamates; D002800:Cholinesterase Inhibitors; D048448:Phenylcarbamates; D003577:Cytochrome P-450 Enzyme System; D000068836:Rivastigmine