Safety and tolerability of transdermal and oral rivastigmine in Alzheimer’s disease and Parkinson’s disease dementia
Abstract
Importance of the field Cholinesterase inhibitors are the mainstay of symptomatic therapy for Alzheimer's disease (AD). Rivastigmine, an inhibitor of both acetylcholinesterase and butyrylcholinesterase, is available as a transdermal patch and in oral forms. It is also approved for the treatment of Parkinson's disease dementia (PDD) in many countries. The objective of this article is to review the safety and tolerability profile of transdermal and oral rivastigmine in AD and PDD patients. Areas covered in this review Articles were identified by searching MEDLINE in July 2009 using the terms rivastigmine, Exelon, ENA 713 and clinical trial. All double-blind, placebo-controlled randomized trials in which rivastigmine monotherapy was administered to AD or PDD patients for longer than 2 weeks were included. What the reader will gain This article provides a comprehensive summary of currently available safety data on rivastigmine. Take home message The main adverse events reported with rivastigmine therapy are gastrointestinal in nature. However, the transdermal patch appears to reduce these side effects, allowing more patients to access higher therapeutic doses. Overall, the safety profile of rivastigmine is favorable and the improved tolerability offered by the rivastigmine patch suggests that transdermal delivery may be the best way to deliver this drug in AD and PDD patients.
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Cholinesterase inhibitors can contribute to nausea, vomiting, diarrhea, and weight loss, and several studies have documented increased GI adverse events with these agents.
“Cholinesterase inhibitors can contribute to nausea, vomiting, diarrhea, and weight loss, and several studies have specifically documented increased GI adverse events with these agents (Darreh-Shori et al., 2010; Farlow et al., 2011).”
From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as Darreh-Shori et al., 2010
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- Authors
- Darreh-Shori, T., & Jelic, V.
- Venue
- Expert Opinion on Drug Safety
- Publisher
- Informa UK Limited
- Published
- 2009-12-20
- Volume
- 9
- Issue
- 1
- Pages
- 167-176
- ISSN
- 1474-0338 (ISSN-L)
- 1744-764X
- OpenAlex
- W2022726721
- Cited by
- 51
- References
- 47
- Citations by year
- 2026: 3 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 3 · 2016: 5 · 2015: 6 · 2014: 7 · 2013: 5 · 2012: 4
- FWCI
- 3.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Opinion on Drug Safety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- rivastigmine, transdermal patch, Alzheimer's disease, Parkinson's disease dementia, cholinesterase inhibitors, drug safety, tolerability, gastrointestinal adverse effects, acetylcholinesterase inhibition, butyrylcholinesterase inhibition
- MeSH terms
- Rivastigmine, Administration, Cutaneous, Administration, Oral, Alzheimer Disease, Cholinesterase Inhibitors, Dementia, Humans, Nausea, Parkinson Disease, Vomiting, Randomized Controlled Trials as Topic, Treatment Outcome, Dermatitis, Irritant, Phenylcarbamates
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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