Donepezil, Rivastigmine & Galantamine: Use in Renal and Hepatic Impairment.

Donepezil, Rivastigmine & Galantamine:

Use in Renal and Hepatic Impairment

 

 

Donepezil

    • Single doses of donepezil can be safely administered to patients with moderately to severely impaired renal function (creatinine clearance < 30 ml/ min)

 

    • Multiple doses can be safely administered to patients with moderately impaired renal function (creatinine clearance 17–33 ml/min)

 

  • Multiple-dose studies of donepezil in patients with hepatic impairment (not to exceed Grade B as defined by the Child-Pugh Classification) indicate that donepezil 5 mg/day is a safe and well-tolerated treatment.

 

Source: Br J Clin Pharmacol. Nov 2004; 58(Suppl 1): 1–8.

Rivastigmine

    • In patients with moderate to severe renal impairment (glomerular filtration rate <50 mL/min), clearance of oral rivastigmine was reduced. Accordingly, such patients may be able to only tolerate lower doses.

 

    • In patients with mild or moderate hepatic impairment (Child-Pugh score 5 to 9), clearance of oral rivastigmine was reduced. Accordingly, such patients may be able to only tolerate lower doses.

 

  • No data are available on the use of rivastigmine in patients with severe hepatic impairment.

 

Source: Rivastigmine Package Insert

Galantamine

    • Use with caution in patients with mild-to-moderate liver impairment; not recommended in severe impairment.

 

  • Use with caution in patients with moderate renal impairment; not recommended in severe impairment (CrCl <9 mL/minute).

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Dr. Harvinder Singh, M.D. (Admin)


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