OBJECT DRUGS

Cholinesterase Inhibitors:

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

PRECIPITANT DRUGS

Anti-Parkinson Anticholinergics:

• Benztropine (Cogentin)
• Biperiden (Akineton)
• Procyclidine (Kemadrin)
• Trihexyphenidyl (Artane)

Comment:

The cholinesterase inhibitors used to treat Alzheimer's dementia are cholinergic, while the anti-Parkinson drugs listed above are anticholinergic drugs. Thus, one would expect that these anti-Parkinson drugs would inhibit the efficacy of cholinesterase inhibitors. The clinical evidence suggests that this may occur.

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.