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Switching from donepezil tablets to rivastigmine transdermal patch in Alzheimer’s disease


Sadowsky, Carl H., Dengiz, Alan, Olin, Jason T., Koumaras, Barbara, Meng, Xiangyi, Brannan, Stephen


American Journal Of Alzheimer's Disease And Other Dementias, Volume: 24, No.: 3, Pages.: 267-275

Year of Publication



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 beta blockers.;

Bibtex Citation

@article{Sadowsky_2009, doi = {10.1177/1533317509333037}, url = {}, year = 2009, month = {mar}, publisher = {{SAGE} Publications}, volume = {24}, number = {3}, pages = {267--275}, author = {C. H. Sadowsky and A. Dengiz and J. T. Olin and B. Koumaras and X. Meng and S. Brannan}, title = {Switching from Donepezil Tablets to Rivastigmine Transdermal Patch in Alzheimer{textquotesingle}s Disease}, journal = {American Journal of Alzheimer{textquotesingle}s Disease and Other Dementias} }


administration cutaneous, adverse, aged, alzheimer disease, appetite, cholinesterase inhibitors, constipation, donepezil, drug administration schedule, drug therapy, electrocardiography, epidemiology, events, female, humans, indans, male, nausea, patch, phenylcarbamates, piperidines, prospective studies, rivastigmine, therapeutic use, time factors, to, transdermal

Countries of Study


Types of Dementia

Alzheimer’s Disease

Types of Study

Cohort Study

Type of Outcomes


Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Anti-Alzheimer medications, e.g.: donezepil, galantamine, rivastigmine, memantime