Understanding Alzheimer Disease Medications (cont.)
Francisco Talavera, PharmD, PhD
Medications for Alzheimer's Disease
Cholinesterase inhibitors include donepezil (Aricept), galantamine (Reminyl), rivastigmine (Exelon), and tacrine (Cognex).
- How cholinesterase inhibitors work: Cholinesterase is an enzyme that breaks down a chemical in the brain called acetylcholine. Acetylcholine acts as an important messaging system in the brain. Brain acetylcholine levels are low in most people with Alzheimer's disease. Cholinesterase inhibitors improve acetylcholine levels by inhibiting the enzyme that breaks down acetylcholine. The first cholinesterase inhibitor, tacrine, has largely been replaced by newer drugs with low risk of liver toxicity.
- Who should not use these medications: Individuals with the following conditions should not take cholinesterase inhibitors.
- Use: Administered orally (by mouth)
- Donepezil may be taken with or without food.
- Galantamine and rivastigmine should be taken with food or milk.
- Tacrine should be taken on an empty stomach at least 1 hour before meals (if stomach upset occurs it may be taken with food, although with food in the stomach, less of the drug may be absorbed).
- Drug or food interactions: Additive effects may occur when administered with succinyl choline, other cholinesterase inhibitors, or cholinergic blockers. Quinidine or ketoconazole increase cholinesterase accumulation in the body and cause toxicity. When taken with
aspirin, ibuprofen, or arthritis medicine, it may increase the risk of stomach ulcers. Avoid drugs that counteract acetylcholine's effects, such as scopolamine (Transderm-Scop), tolterodine (Detrol), oxybutynin (Ditropan), or benztropine (Cogentin). If taking tacrine, avoid other drugs or herbal products that may increase liver toxicity, such as atorvastatin, estrogen, or acetaminophen.
- Side effects:
- Common side effects include the following:
- Contact the doctor immediately if the following occur:
- Use caution if experiencing any of the following:
Must Read Articles Related to Understanding Alzheimer Disease Medications
Alzheimer's disease (AD) is the most common cause of dementia in industrialized nations. Dementia is a brain disorder that interferes with a person's ability to...learn more >>
Alzheimer's Disease FAQs
Alzheimer's disease is a fatal brain disorder. Familial and sporadic are the two types of Alzheimer's disease. The three stages include early, intermediate, and...learn more >>
Alzheimer's Disease Stages: Symptoms and Signs
Alzheimer's disease is one of the many causes of dementia. Symptoms of Alzheimer's disease typically progress over a period of years. There are warning signs of...learn more >>