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American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2009 Jun-Jul;24(3):267–275. doi: 10.1177/1533317509333037

Switching from Donepezil Tablets to Rivastigmine Transdermal Patch in Alzheimer's Disease

Carl H Sadowsky 1, Alan Dengiz 2, Jason T Olin 3, Barbara Koumaras 4, Xiangyi Meng 5, Stephen Brannan 6; US38 study group
PMCID: PMC10846161  PMID: 19293130

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 β blockers.

Keywords: Alzheimer's disease, clinical trial, donepezil, rivastigmine, switching, transdermal patch

Full Text

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Contributor Information

Carl H. Sadowsky, Premiere Research Institute, Palm Beach Neurology, West Palm Beach, Florida, CHsadow@aol.com, Nova SE University, Fort Lauderdale, Florida.

Alan Dengiz, St Joseph Mercy Health System, Ann Arbor, Michigan.

Jason T. Olin, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey.

Barbara Koumaras, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey.

Xiangyi Meng, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey.

Stephen Brannan, Takeda Pharmaceuticals North America, Deerfield, Illinois.

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