Rivastigmine transidermal patch: In the treatment of dementia of the Alzheimer's type

The cholinesterase inhibitor rivastigmine is now available as a transdermal patch for use in the treatment of mild to moderate dementia of the Alzheimer's type. The transdermal patch gradually releases rivastigmine over the application period. There was less fluctuation between plasma peak and trough rivastigmine concentrations with the patch than with the capsule formulation. The rivastigmine 9.5 mg/24 hours patch was effective in patients with Alzheimer's disease, according to the results of a well designed, 24-week trial. A significant improvement in Alzheimer's Disease Assessment Scale - Cognitive subscale (ADASCog) scores and significantly lower Alzheimer's Disease Cooperative Study - Clinical Global Impression of Change scores were seen with the rivastigmine 9.5 mg/24 hours patch versus placebo. In addition, treatment with the rivastigmine 9.5 mg/24 hours patch was noninferior to rivastigmine 6mg twice-daily capsules, as assessed by ADAS-Cog scores. Significantly more caregivers of study patients preferred administering the patch formulation of rivastigmine than the capsule formulation. The rivastigmine 9.5 mg/24 hours patch was generally well tolerated by patients with Alzheimer's disease. The incidence of adverse events (including nausea and vomiting) in the rivastigmine 9.5 mg/24 hours patch group was not significantly different to that in the placebo group. However, several adverse events such as nausea and vomiting occurred in significantly more rivastigmine capsule recipients than in placebo recipients.