title: Switching from donepezil tablets to rivastigmine transdermal patch in Alzheimer's disease.
abstract: OBJECTIVE
  Evaluate safety and tolerability of switching from donepezil to rivastigmine transdermal patch in patients with mild to moderate Alzheimer's disease.
  
  
  METHODS
  Prospective, parallel-group, open-label study to evaluate immediate or delayed switch from 5-10 mg/day donepezil to 4.6 mg/24 h rivastigmine following a 4-week treatment period.
  
  
  RESULTS
  Rates of discontinuation due to any reason or adverse events were similar between groups. Incidences of gastrointestinal adverse events were 3.8% in the immediate and 0.8% in the delayed switch group. No patients discontinued secondary to nausea and vomiting. Discontinuations due to application site reactions were low (2.3%). Asymptomatic bradycardia was more common following the immediate switch (2.3% vs 0%); however, these patients had coexisting cardiac comorbidities.
  
  
  CONCLUSIONS
  Both switch strategies were safe and well tolerated. The majority of patients may be able to switch directly to rivastigmine patches without a withdrawal period. Appropriate clinical judgment should be used for patients with existing bradycardia or receiving beta blockers.
authors.affiliation: Nova SE University, Fort Lauderdale, Florida, USA. CHsadow@aol.com
authors.forename: Carl H
authors.initials: CH
authors.lastname: Sadowsky
authors.forename: Alan
authors.initials: A
authors.lastname: Dengiz
authors.forename: Jason T
authors.initials: JT
authors.lastname: Olin
authors.forename: Barbara
authors.initials: B
authors.lastname: Koumaras
authors.forename: Xiangyi
authors.initials: X
authors.lastname: Meng
authors.forename: Stephen
authors.initials: S
authors.lastname: Brannan
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy*; D001066:Appetite; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003248:Constipation / Q000453:epidemiology; D000077265:Donepezil; D004334:Drug Administration Schedule; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D008297:Male; D009325:Nausea / Q000453:epidemiology; D048448:Phenylcarbamates / Q000627:therapeutic use*; D010880:Piperidines / Q000627:therapeutic use; D011446:Prospective Studies; D000068836:Rivastigmine; D013997:Time Factors
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D048448:Phenylcarbamates; D010880:Piperidines; D000077265:Donepezil; D000068836:Rivastigmine