Lack of adverse pharmacodynamic drug interactions with rivastigmine and twenty-two classes of medications

• Published in: International journal of geriatric psychiatry 2000-03, Vol.15 (3), p.242-247
• Main Authors: Grossberg, George T., Stahelin, Hannes B., Messina, John C., Anand, Ravi, Veach, Jeffrey
• Format: Article
• Language: English
• Subjects: adverse events; Aged; Alzheimer Disease - drug therapy; Alzheimer Disease - epidemiology; Alzheimer's disease; Carbamates - pharmacology; Carbamates - therapeutic use; Cholinesterase Inhibitors - pharmacology; Cholinesterase Inhibitors - therapeutic use; co-morbidity; Comorbidity; Cytochrome P-450 Enzyme System - metabolism; Data Interpretation, Statistical; drug interaction; Drug Interactions; Female; Humans; Male; Phenylcarbamates; Polypharmacy; Prospective Studies; Randomized Controlled Trials as Topic; Rivastigmine
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/(SICI)1099-1166(200003)15:3<242::AID-GPS110>3.0.CO;2-7

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. Copyright © 2000 John Wiley & Sons, Ltd.