OBJECT DRUGS

Cholinesterase Inhibitors:

• Donepezil (Aricept, etc.)
• Galantamine (Razadyne, etc.)
• Rivastigmine (Exelon)

PRECIPITANT DRUGS

Antiemetic Anticholinergics:

• Cyclizine (Marezine, etc.)
• Dimenhydrinate (Dramamine)
• Meclizine (Antivert, etc.)
• Prochlorperazine (Compazine)
• Scopolamine (Transderm Scop, etc.)

Comment:

The cholinesterase inhibitors used to treat Alzheimer's dementia are cholinergic, while the antiemetic drugs listed above are anticholinergic drugs. Thus, one would expect that these antiemetic drugs would inhibit the efficacy of cholinesterase inhibitors. The clinical evidence suggests that this may occur. Short-term use of the antiemetic may be less likely to cause problems.

Class 3: Assess Risk & Take Action if Necessary

• Consider Alternative: Consider using an alternative to one of the drugs.
• Monitor: If the combination is used, monitor for evidence of reduced efficacy of the cholinesterase inhibitor.