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Rivastigmine Disease Interactions

There are 5 disease interactions with rivastigmine:

Major

Cholinesterase Inhibitor (Includes Rivastigmine) ↔ Bradycardia

Severe Potential Hazard, High plausibility

Applies to: Arrhythmias

Due to their pharmacological action, cholinesterase inhibitors can have a vagotonic effect on the sinoatrial and atrioventricular nodes producing bradycardia or heart block. Therapy with cholinesterase inhibitors should be administered cautiously in patients with preexisting bradycardia or underlying cardiac conduction abnormalities. Syncopal episodes have been reported in patients with and without cardiac abnormalities. Atropine may be used to reverse bradycardia produced by cholinesterase inhibitors.

References

  1. "Product Information. Humorsol Ophthalmic Solution (demecarium bromide ophthalmic)." Merck & Co, Inc, West Point, PA.
  2. Baldessarini RJ, Gelenberg AJ "Using physostigmine safely." Am J Psychiatry 136 (1979): 1608-9
  3. Janowsky DS, Risch SC, Huey LY, Kennedy B, Ziegler M "Effects of physostigmine on pulse, blood pressure, and serum epinephrine levels." Am J Psychiatry 142 (1985): 738-40
  4. "Product Information. Phospholine iodide (echothiophate iodide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  5. "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  6. "Product Information. Eserine (physostigmine ophthalmic)." Ciba Vision Ophthalmics, Duluth, GA.
  7. "Product Information. Aricept (donepezil)." Pfizer US Pharmaceuticals, New York, NY.
  8. Wilcock GK, Surmon D, Forsyth D, Morgan R "Cholinergic side-effects of tetrahydroaminoacridine." Lancet 2 (1988): 1305
  9. "Product Information. Cognex (tacrine)." Parke-Davis, Morris Plains, NJ.
  10. "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  11. Dysken MW, Janowsky DS "Dose-related physostigmine-induced ventricular arrhythmia: case report." J Clin Psychiatry 46 (1985): 446-7
View all 11 references
Major

Cholinesterase Inhibitor (Includes Rivastigmine) ↔ Bronchospasm

Severe Potential Hazard, Moderate plausibility

Applies to: Asthma, Chronic Obstructive Pulmonary Disease

Cholinesterase inhibitors inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Therapy with cholinesterase inhibitors should be administered cautiously in patients with respiratory dysfunction, history of asthma or obstructive pulmonary disease. Monitoring respiratory function during dosage initiation and adjustment is recommended. Use of atropine along with discontinuation of the cholinesterase inhibitor may be required for serious respiratory distress. Neostigmine may produce more severe muscarinic side effects than does pyridostigmine and ambenonium. However, the duration of action is longest for ambenonium and shortest for edrophonium. Echothiophate iodide ophthalmic may be systemically absorbed and cautious use is recommended in these patients.

References

  1. "Product Information. Humorsol Ophthalmic Solution (demecarium bromide ophthalmic)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Phospholine iodide (echothiophate iodide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. "Product Information. Eserine (physostigmine ophthalmic)." Ciba Vision Ophthalmics, Duluth, GA.
  4. "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  5. "Product Information. Aricept (donepezil)." Pfizer US Pharmaceuticals, New York, NY.
  6. Wilcock GK, Surmon D, Forsyth D, Morgan R "Cholinergic side-effects of tetrahydroaminoacridine." Lancet 2 (1988): 1305
  7. "Product Information. Cognex (tacrine)." Parke-Davis, Morris Plains, NJ.
  8. "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
View all 8 references
Major

Cholinesterase Inhibitor (Includes Rivastigmine) ↔ Parkinsonism

Severe Potential Hazard, High plausibility

Applies to: Parkinsonism

Cholinesterase inhibitors should be used with caution in patients with parkinsonism. Some of these drugs might be contraindicated in these patients (refer to specific prescribing information). Symptoms of Parkinson's disease may be exacerbated with the increase in cholinergic activity. Caregivers and patients should be advised.

References

  1. el-Yousef MK, Janowsky D, Davis JM, Sekerke HJ "Reversal of antiparkinsonian drug toxicity by physostigmine: a controlled study." Am J Psychiatry 130 (1973): 141-5
  2. "Product Information. Cognex (tacrine)." Parke-Davis, Morris Plains, NJ.
  3. "Product Information. Humorsol Ophthalmic Solution (demecarium bromide ophthalmic)." Merck & Co, Inc, West Point, PA.
  4. "Product Information. Phospholine iodide (echothiophate iodide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  5. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
  6. "Product Information. Aricept (donepezil)." Pfizer US Pharmaceuticals, New York, NY.
  7. "Product Information. Eserine (physostigmine ophthalmic)." Ciba Vision Ophthalmics, Duluth, GA.
View all 7 references
Major

Cholinesterase Inhibitor (Includes Rivastigmine) ↔ Pud

Severe Potential Hazard, High plausibility

Applies to: Peptic Ulcer

The use of cholinesterase inhibitors is associated with an increase in gastric acid secretion and gastric contractions. Therapy with cholinesterase inhibitors should be administered cautiously in patients with peptic ulcer disease.

References

  1. "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  2. "Product Information. Cognex (tacrine)." Parke-Davis, Morris Plains, NJ.
  3. "Product Information. Eserine (physostigmine ophthalmic)." Ciba Vision Ophthalmics, Duluth, GA.
  4. "Product Information. Aricept (donepezil)." Pfizer US Pharmaceuticals, New York, NY.
  5. "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  6. "Product Information. Humorsol Ophthalmic Solution (demecarium bromide ophthalmic)." Merck & Co, Inc, West Point, PA.
  7. "Product Information. Phospholine iodide (echothiophate iodide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 7 references
Major

Cholinesterase Inhibitor (Includes Rivastigmine) ↔ Seizures

Severe Potential Hazard, Moderate plausibility

Applies to: Seizures

Cholinesterase inhibitors have been associated with convulsions and tremor. Therapy with cholinesterase inhibitors should be administered cautiously in patients with seizure disorders.

References

  1. "Product Information. Prostigman (neostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  2. Stewart GO "Convulsions after physostigmine." Anaesth Intensive Care 7 (1979): 283
  3. "Product Information. Cognex (tacrine)." Parke-Davis, Morris Plains, NJ.
  4. "Product Information. Humorsol Ophthalmic Solution (demecarium bromide ophthalmic)." Merck & Co, Inc, West Point, PA.
  5. "Product Information. Phospholine iodide (echothiophate iodide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. "Product Information. Aricept (donepezil)." Pfizer US Pharmaceuticals, New York, NY.
  7. "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  8. "Product Information. Eserine (physostigmine ophthalmic)." Ciba Vision Ophthalmics, Duluth, GA.
View all 8 references

rivastigmine drug Interactions

There are 615 drug interactions with rivastigmine

rivastigmine alcohol/food Interactions

There is 1 alcohol/food interaction with rivastigmine

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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