title: Rivastigmine transdermal system for the treatment of mild to moderate Alzheimer's disease.
abstract: Today patients with mild to moderate Alzhiemer's disease (AD) have a treatment approach choice: oral or transdermal delivery. The aim of this review was to provide a concise, comprehensive overview of the clinically relevant safety, tolerability and efficacy information available for the rivastigmine transdermal system. Relevant articles were identified through a MEDLINE search of publications in the past 3 years using the terms 'rivastigmine' and 'transdermal' or 'patch'. Efficacy, safety and tolerability of the rivastigmine patch vs. placebo were established in a large, international, 24-week, double-blind, randomised clinical trial and subsequent 28-week open-label extension study. Drug exposure with the 9.5 mg/24 h rivastigmine patch was not significantly different to that provided by an oral capsule dose of 12 mg/day. Most frequently observed adverse events were gastrointestinal. In the primary study, incidences of nausea, vomiting and diarrhoea were: 5%, 3% and 3% respectively in the placebo group; 7%, 6% and 6% in the 9.5 mg/24 h rivastigmine patch group; and 23%, 17% and 5% in the 12 mg/day capsule group. Most patients experienced no, slight or mild application-site skin reactions. De novo patients or those taking oral rivastigmine or donepezil may tolerate a switch to rivastigmine patch. By providing drug exposure that is not significantly different to the highest recommended rivastigmine capsule dose (12 mg/day), with less fluctuation over 24 h, rivastigmine patch offers similar efficacy with an improved tolerability profile. The rivastigmine patch provides a viable treatment option for patients with mild to moderate AD.
authors.affiliation: St Louis University School of Medicine, St Louis, MO, USA. Grossbgt@aol.com <Grossbgt@aol.com>
authors.forename: G T
authors.initials: GT
authors.lastname: Grossberg
authors.forename: C
authors.initials: C
authors.lastname: Sadowsky
authors.forename: J T
authors.initials: JT
authors.lastname: Olin
mesh_terms: D000279:Administration, Cutaneous; D000544:Alzheimer Disease / Q000188:drug therapy*; D006801:Humans; D018696:Neuroprotective Agents / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D048448:Phenylcarbamates / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D000068836:Rivastigmine; D016896:Treatment Outcome
chemical_list: D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D000068836:Rivastigmine