Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2009 Jun-Jul;24(3):267-75.
doi: 10.1177/1533317509333037. Epub 2009 Mar 16.

Switching from donepezil tablets to rivastigmine transdermal patch in Alzheimer's disease

Carl H Sadowsky  1 , Alan Dengiz, Jason T Olin, Barbara Koumaras, Xiangyi Meng, Stephen Brannan; US38 study group
Collaborators, Affiliations
Randomized Controlled Trial

Switching from donepezil tablets to rivastigmine transdermal patch in Alzheimer's disease

Carl H Sadowsky et al. Am J Alzheimers Dis Other Demen. 2009 Jun-Jul.

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.

Conclusion: 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.

PubMed Disclaimer

References

    1. Doody RS, Stevens JC, Beck C., et al. Practice parameter: management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56: 1154-1166. - PubMed
    1. Geldmacher DS Treatment guidelines for Alzheimer's disease: redefining perceptions in primary care. Prim Care Companion J Clin Psychiatry. 2007;9:113-121. - PMC - PubMed
    1. Small G., Dubois B. A review of compliance to treatment in Alzheimer's disease: potential benefits of a transdermal patch. Curr Med Res Opin. 2007;23:2705-2713. - PubMed
    1. Ryan AA Medication compliance and older people: a review of the literature. Int J Nurs Stud. 1999;36:153-162. - PubMed
    1. Gauthier S., Emre M., Farlow MR, Bullock R., Grossberg GT, Potkin SG Strategies for continued successful treatment of Alzheimer's disease: switching cholinesterase inhibitors. Curr Med Res Opin. 2003;19: 707-714. - PubMed

Publication types