Pharmacokinetics of a novel transdermal rivastigmine patch for the treatment of Alzheimer's disease

A review

A. Kurz, Martin Farlow, G. Lefèvre

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background: Cholinesterase inhibitors have all been available in oral formulations, but a rivastigmine transdermal patch has now been developed and is approved in many countries worldwide for the treatment of mild-to-moderate Alzheimer's disease (AD) (including the USA, Latin America, Europe and Asia). Objectives: To review the available pharmacokinetic data that supported the rationale behind the development of the rivastigmine transdermal patch and its clinical effects in dementia therapy. This article will also discuss how the patch may alter the treatment paradigm for patients with AD. Results: The 9.5 mg-24 h rivastigmine patch was shown to provide comparable exposure to the highest recommended doses of capsules (12 mg-day) with significantly lower maximum plasma concentration (Cmax 8.7 vs. 21.6 ng-ml) and slower absorption rate (tmax 8.1 vs. 1.4 h). In a clinical trial of 1195 AD patients, this translated into similar efficacy with three times fewer reports of nausea and vomiting (7.2% vs. 23.1%, and 6.2% vs. 17.0% respectively). Consequently, more patients in the 9.5 mg-24 h patch group achieved their target therapeutic dose at the end of the study, compared with those in the 12 mg-day capsule group (95.9% vs. 64.4%). Conclusion: The rivastigmine patch provides continuous drug delivery over 24 h and similar efficacy to the highest recommended dose of oral rivastigmine with improved tolerability. This may allow patients to achieve optimal therapeutic doses and to benefit from a longer duration of treatment.

Original languageEnglish
Pages (from-to)799-805
Number of pages7
JournalInternational Journal of Clinical Practice
Volume63
Issue number5
DOIs
StatePublished - May 2009

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Rivastigmine
Transdermal Patch
Alzheimer Disease
Pharmacokinetics
Capsules
Therapeutics
Latin America
Cholinesterase Inhibitors
Nausea
Vomiting
Dementia
Clinical Trials

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pharmacokinetics of a novel transdermal rivastigmine patch for the treatment of Alzheimer's disease : A review. / Kurz, A.; Farlow, Martin; Lefèvre, G.

In: International Journal of Clinical Practice, Vol. 63, No. 5, 05.2009, p. 799-805.

Research output: Contribution to journalArticle

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