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Sadowsky CH, Farlow MR, Atkinson L, et al. Switching From Donepezil to Rivastigmine Is Well Tolerated: Results of an Open-Label Safety and Tolerability Study. Prim Care Companion J Clin Psychiatry. 2005;7(2):43-48doi: 10.4088/pcc.v07n0201.
Sadowsky, C. H., Farlow, M. R., Atkinson, L., Steadman, J., Koumaras, B., Chen, M., & Mirski, D. (2005). Switching From Donepezil to Rivastigmine Is Well Tolerated: Results of an Open-Label Safety and Tolerability Study. Primary care companion to the Journal of clinical psychiatry, 7(2), 43-48. https://doi.org/10.4088/pcc.v07n0201
Sadowsky, Carl H, et al. "Switching From Donepezil to Rivastigmine Is Well Tolerated: Results of an Open-Label Safety and Tolerability Study." Primary care companion to the Journal of clinical psychiatry vol. 7,2 (2005): 43-48. doi: https://doi.org/10.4088/pcc.v07n0201
Sadowsky CH, Farlow MR, Atkinson L, Steadman J, Koumaras B, Chen M, Mirski D. Switching From Donepezil to Rivastigmine Is Well Tolerated: Results of an Open-Label Safety and Tolerability Study. Prim Care Companion J Clin Psychiatry. 2005;7(2):43-48. doi: 10.4088/pcc.v07n0201. PMID: 15841194; PMCID: PMC1079694.
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Prim Care Companion J Clin Psychiatry. 2005;7(2):43-48. doi: 10.4088/pcc.v07n0201.

Switching From Donepezil to Rivastigmine Is Well Tolerated: Results of an Open-Label Safety and Tolerability Study.

Primary care companion to the Journal of clinical psychiatry

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

Affiliations

  1. Department of Neurology, Nova Southeastern University, Fort Lauderdale, Fla. ; Department of Neurology, Indiana University School of Medicine, Indianapolis, Ind. ; and Novartis Pharmaceuticals Corporation, East Hanover, N.J.

PMID: 15841194 PMCID: PMC1079694 DOI: 10.4088/pcc.v07n0201

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.

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