For patients with significant side effects to a cholinesterase inhibitor, do you try another medication in the class or avoid it altogether?
If you have significant side effects, GI and/or cardiac with one of the cholinesterase inhibitors, would you try using another medication or would you avoid using the whole class and use an NMDA antagonist instead?
1 Answer
Mednet MemberInvited Expert
Neurology · The University of Texas Health Science Center at San Antonio
Answered on · Updated on
Firstly, I titrate up the medication so that if there is a side effect, I can retreat to my last tolerated dose. If the side effect is dizziness or faintness, then I will stop trying to escalate the dose. If the side effect is vivid dreaming, then one might try to take the medication in the morning. If the symptom is dose-related, as is the case with diarrhea, one may give the medication in divided doses or try a Rivastigmine patch.
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