Clinically Relevant Drug Interactions with Anti-Alzheimer's Drugs

Title:Clinically Relevant Drug Interactions with Anti-Alzheimer's Drugs

Volume: 16 Issue: 4

Author(s): Filippo Caraci*, Janet Sultana, Filippo Drago and Edoardo Spina

Affiliation:

• Department of Drug Sciences, University of Catania, Viale Andrea Doria 6, 95125 Catania,Italy

Keywords: Alzheimer's disease, cholinesterase inhibitors, memantine, drug interactions, pharmacodynamics, pharmacokinetics.

Abstract: Background: The aging world population had led to an increase in the prevalence of Alzheimer’s disease (AD). The drugs used to slow down the onset of AD, galantamine, donepezil, rivastigmine and memantine, are generally well-tolerated. However, drug interactions between these drugs and other drugs are an important aspect of patient safety that should be borne in mind, particularly given the high burden of polypharmacy in the elderly. The aim of this review is to provide an updated review of clinically significant drug-drug interactions concerning drugs approved for AD.

Method: PubMed was searched for relevant keywords. No time limit was imposed but only articles in English published in peer-reviewed journals were selected. Relevant literature was also identified from the references of identified articles. Further information was obtained from drug summary of product characteristics.

Results: The major pharmacokinetic interactions identified concerned fluoxetine, paroxetine and ketoconazole when used with galantamine or donepezil. On the other hand, the major potential pharmacodynamic interactions concerned anti-dementia drugs and general anesthesia agents, anti-cholinergic drugs, conventional antipsychotics and bradycardia-inducing drugs. In clinical practice memantine shows a lower potential for pharmacodynamic drug-drug interactions (DDIs) compared to other drug classes.

Conclusion: The concomitant use of anti-dementia drugs with other drugs can have variable clinical effects, making appropriate prescribing of these drugs very challenging. A simple and coherent way of presenting evidence on complex drug interaction information from heterogenous sources to clinicians is needed in order for the voluminous data available to have an impact on clinical practice.

Cite this article as:

Caraci Filippo*, Sultana Janet, Drago Filippo and Spina Edoardo, Clinically Relevant Drug Interactions with Anti-Alzheimer's Drugs, CNS & Neurological Disorders - Drug Targets 2017; 16 (4) . https://dx.doi.org/10.2174/1871527316666170303144817

DOI https://dx.doi.org/10.2174/1871527316666170303144817	Print ISSN 1871-5273
Publisher Name Bentham Science Publisher	Online ISSN 1996-3181