Drug Interactions between formoterol / glycopyrrolate and rivastigmine

Using rivastigmine together with glycopyrrolate may decrease the benefits of rivastigmine in the treatment of dementia. Rivastigmine may also counteract the benefit of glycopyrrolate. Glycopyrrolate should generally be avoided in patients with Alzheimer's disease or other cognitive problems. Glycopyrrolate may also adversely affect elderly patients by producing symptoms ranging from mild thinking impairment to delirium. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor.

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Consumer information for this interaction is not currently available.

MONITOR: Acetylcholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes, which occasionally manifest as bradycardia or heart block (<2%). Because bradycardia is a risk factor for torsade de pointes, a theoretical risk exists when combined with agents that prolong the QT interval. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors including, but not limited to congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation may vary depending on the dosage(s) and specific drug(s) involved.

MANAGEMENT: Caution is advised when acetylcholinesterase inhibitors are used with drugs that can prolong the QT interval. Patients should be monitored for bradycardia, atrioventricular block and syncope, and advised to seek medical attention if they experience dizziness, lightheadedness, fainting, shortness of breath, or slow or irregular heartbeat.