Switching from donepezil to rivastigmine is well tolerated

Results of an open-label safety and tolerability study

Carl H. Sadowsky, Martin Farlow, Leone Atkinson, Jennifer Steadman, Barbara Koumaras, Michael Chen, Dario Mirski

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Transitioning patients between cholinesterase inhibitors was thought to require a washout period to avoid cholinergic toxicity; however, evidence suggests that abrupt discontinuation of donepezil may lead to cognitive decline. We evaluated the safety and tolerability of an immediate switch from donepezil to rivastigmine. Method: This is an analysis of the safety and tolerability data from the first 28 days of an open-label, multicenter, prospective trial, conducted from August 2002 to August 2003, in which patients satisfying NINCDS-ADRDA criteria for probable Alzheimer's disease were administered rivastigmine 1.5 mg b.i.d. within 24 to 36 hours of donepezil discontinuation. Results are compared with adverse event rates from a retrospective analysis of a pivotal, placebo-controlled trial examining patients not previously treated with a cholinesterase inhibitor. Results: Fifty-eight of 61 patients completed the first 28 days, with no suspected drug-related discontinuations during this period. Incidence of overall gastrointestinal adverse events at day 7 was 8.2%, and at day 28 was 11.5%. The corresponding rate for rivastigmine-treated patients in the retrospective analysis of the pivotal trial for day 7 was 3.3%. Conclusion: These study results suggest that transitioning patients from donepezil to rivastigmine without a washout period is safe and well tolerated.

Original languageEnglish
Pages (from-to)43-48
Number of pages6
JournalPrimary Care Companion to the Journal of Clinical Psychiatry
Volume7
Issue number2
StatePublished - 2005

Fingerprint

Rivastigmine
Safety
Cholinesterase Inhibitors
Cholinergic Agents
Multicenter Studies
donepezil
Alzheimer Disease
Placebos

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Switching from donepezil to rivastigmine is well tolerated : Results of an open-label safety and tolerability study. / Sadowsky, Carl H.; Farlow, Martin; Atkinson, Leone; Steadman, Jennifer; Koumaras, Barbara; Chen, Michael; Mirski, Dario.

In: Primary Care Companion to the Journal of Clinical Psychiatry, Vol. 7, No. 2, 2005, p. 43-48.

Research output: Contribution to journalArticle

Sadowsky, Carl H. ; Farlow, Martin ; Atkinson, Leone ; Steadman, Jennifer ; Koumaras, Barbara ; Chen, Michael ; Mirski, Dario. / Switching from donepezil to rivastigmine is well tolerated : Results of an open-label safety and tolerability study. In: Primary Care Companion to the Journal of Clinical Psychiatry. 2005 ; Vol. 7, No. 2. pp. 43-48.
@article{fb030d93679f435b87c4c62c8821ebc2,
title = "Switching from donepezil to rivastigmine is well tolerated: Results of an open-label safety and tolerability study",
abstract = "Background: Transitioning patients between cholinesterase inhibitors was thought to require a washout period to avoid cholinergic toxicity; however, evidence suggests that abrupt discontinuation of donepezil may lead to cognitive decline. We evaluated the safety and tolerability of an immediate switch from donepezil to rivastigmine. Method: This is an analysis of the safety and tolerability data from the first 28 days of an open-label, multicenter, prospective trial, conducted from August 2002 to August 2003, in which patients satisfying NINCDS-ADRDA criteria for probable Alzheimer's disease were administered rivastigmine 1.5 mg b.i.d. within 24 to 36 hours of donepezil discontinuation. Results are compared with adverse event rates from a retrospective analysis of a pivotal, placebo-controlled trial examining patients not previously treated with a cholinesterase inhibitor. Results: Fifty-eight of 61 patients completed the first 28 days, with no suspected drug-related discontinuations during this period. Incidence of overall gastrointestinal adverse events at day 7 was 8.2{\%}, and at day 28 was 11.5{\%}. The corresponding rate for rivastigmine-treated patients in the retrospective analysis of the pivotal trial for day 7 was 3.3{\%}. Conclusion: These study results suggest that transitioning patients from donepezil to rivastigmine without a washout period is safe and well tolerated.",
author = "Sadowsky, {Carl H.} and Martin Farlow and Leone Atkinson and Jennifer Steadman and Barbara Koumaras and Michael Chen and Dario Mirski",
year = "2005",
language = "English",
volume = "7",
pages = "43--48",
journal = "The primary care companion for CNS disorders",
issn = "1523-5998",
publisher = "Physicians Postgraduate Press Inc.",
number = "2",

}

TY - JOUR

T1 - Switching from donepezil to rivastigmine is well tolerated

T2 - Results of an open-label safety and tolerability study

AU - Sadowsky, Carl H.

AU - Farlow, Martin

AU - Atkinson, Leone

AU - Steadman, Jennifer

AU - Koumaras, Barbara

AU - Chen, Michael

AU - Mirski, Dario

PY - 2005

Y1 - 2005

N2 - Background: Transitioning patients between cholinesterase inhibitors was thought to require a washout period to avoid cholinergic toxicity; however, evidence suggests that abrupt discontinuation of donepezil may lead to cognitive decline. We evaluated the safety and tolerability of an immediate switch from donepezil to rivastigmine. Method: This is an analysis of the safety and tolerability data from the first 28 days of an open-label, multicenter, prospective trial, conducted from August 2002 to August 2003, in which patients satisfying NINCDS-ADRDA criteria for probable Alzheimer's disease were administered rivastigmine 1.5 mg b.i.d. within 24 to 36 hours of donepezil discontinuation. Results are compared with adverse event rates from a retrospective analysis of a pivotal, placebo-controlled trial examining patients not previously treated with a cholinesterase inhibitor. Results: Fifty-eight of 61 patients completed the first 28 days, with no suspected drug-related discontinuations during this period. Incidence of overall gastrointestinal adverse events at day 7 was 8.2%, and at day 28 was 11.5%. The corresponding rate for rivastigmine-treated patients in the retrospective analysis of the pivotal trial for day 7 was 3.3%. Conclusion: These study results suggest that transitioning patients from donepezil to rivastigmine without a washout period is safe and well tolerated.

AB - Background: Transitioning patients between cholinesterase inhibitors was thought to require a washout period to avoid cholinergic toxicity; however, evidence suggests that abrupt discontinuation of donepezil may lead to cognitive decline. We evaluated the safety and tolerability of an immediate switch from donepezil to rivastigmine. Method: This is an analysis of the safety and tolerability data from the first 28 days of an open-label, multicenter, prospective trial, conducted from August 2002 to August 2003, in which patients satisfying NINCDS-ADRDA criteria for probable Alzheimer's disease were administered rivastigmine 1.5 mg b.i.d. within 24 to 36 hours of donepezil discontinuation. Results are compared with adverse event rates from a retrospective analysis of a pivotal, placebo-controlled trial examining patients not previously treated with a cholinesterase inhibitor. Results: Fifty-eight of 61 patients completed the first 28 days, with no suspected drug-related discontinuations during this period. Incidence of overall gastrointestinal adverse events at day 7 was 8.2%, and at day 28 was 11.5%. The corresponding rate for rivastigmine-treated patients in the retrospective analysis of the pivotal trial for day 7 was 3.3%. Conclusion: These study results suggest that transitioning patients from donepezil to rivastigmine without a washout period is safe and well tolerated.

UR - http://www.scopus.com/inward/record.url?scp=26444560307&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=26444560307&partnerID=8YFLogxK

M3 - Article

VL - 7

SP - 43

EP - 48

JO - The primary care companion for CNS disorders

JF - The primary care companion for CNS disorders

SN - 1523-5998

IS - 2

ER -