By Simon Spichak, MSc | November tenth, 2022
Among the commonest therapies for Alzheimer’s signs could also be prescribed in capsule kind, as an oral answer, and even as a transdermal patch. Being Affected person compares the professionals and cons of every possibility.
This text was written by Being Affected person. Corium, the maker of Adlarity®, a transdermal Alzheimer’s dementia therapy, sponsored the article.
Scientists have made substantial progress in managing Alzheimer’s most debilitating signs: reminiscence loss, confusion, and cognitive impairment. Up to now, three totally different medication have been permitted by the FDA to deal with signs at any stage of Alzheimer’s illness: donepezil (out there beneath the model names Aricept and Adlarity), galantamine (Razadyne) and rivastigmine (Exelon). For sufferers particularly with reasonable to extreme Alzheimer’s, there may be additionally memantine (Namenda).
The primary technology of those medication have been out there in capsule kind, as tablets or capsules. However this previous standby has its drawbacks. Some caregivers discover that whereas drugs could also be efficient at easing signs, some sufferers have bother swallowing them — or they aren’t curious about swallowing them. And a forgotten dose can derail therapy.
Drugmakers innovated to unravel these challenges, and provide different choices to swimsuit totally different sufferers’ wants. The consequence: easier-to-swallow liquid oral options, and leave-on transdermal medicated patches that skip ingestion altogether and solely should be modified both day by day or weekly relying on model.
One research on Alzheimer’s remedy in patch versus capsule kind confirmed that sufferers and caregivers are inclined to choose patches over drugs, as a result of they’re simpler to manage and schedule than drugs. This mentioned, experiences with Alzheimer’s and its signs differ from affected person to affected person, they usually evolve because the illness progresses. Under, Being Affected person dives into the professionals and cons of every format to assist individuals residing with Alzheimer’s and their caregivers discover the best choice for them.
Transdermal patches for Alzheimer’s
In September 2022, biotech firm Corium launched a once-weekly adhesive, transdermal patch known as Adlarity. It administers the drug donepezil, an Alzheimer’s therapy prescribed to mitigate signs like reminiscence loss and confusion, by means of the pores and skin.
In keeping with Corium Chief Medical Officer Charles Oh, patches slowly diffuse the drug into the blood by means of the pores and skin over seven days, saving individuals the additional step of remembering to take a day by day capsule on the proper time. This, Oh mentioned, may very well be an enormous assist in terms of efficacy.
Professionals
“The drug is just good as [long as] the affected person is taking it frequently,” Oh advised Being Affected person. In comparison with the oral formulation, he added, information reveals that sufferers utilizing donepezil (Aldarity) in patch kind have been thrice much less more likely to expertise gastrointestinal uncomfortable side effects, like nausea and diarrhea. It is because the drug is delivered on to the bloodstream bypassing the intestine.
Versus remembering to swallow drugs on a regular basis, transdermal patches are simply utilized by oneself or a caregiver, Oh added.
Rivastigmine (Exelon) can be out there in patch kind from drugmaker Novartis. Rivastigmine (Exelon) patches should be changed day by day whereas donepezil (Adlarity) patches are changed once-per-week. One caregiver shared that the rivastigmine (Exelon) patches labored effectively for his or her mom, lowering diarrhea.
Cons
Novartis’s rivastigmine (Exelon) patches may cause pores and skin irritation for some individuals.
“In my expertise dementia sufferers are usually irritated by the patch and pull it off, so Aricept [in pill form] would most likely be a greater guess,” one caregiver shared in an internet discussion board.
In keeping with Oh, Corium addressed a few of these points related to pores and skin irritability. Oh added that lower than 1 p.c of patches of their trial prompted pores and skin reactions past redness or irritation.
Novartis’s rivastigmine (Exelon) patches, which secured FDA approval in 2007, are usually lined by Medicare. Corium is at present working to make sure the Adlarity patch, which was permitted by the FDA in March of this yr, has Medicare and insurance coverage protection, too, Oh mentioned. In keeping with GoodRx, a four-week provide of donepezil patches (Adlarity) could be bought for $450 with out insurance coverage protection; a 90-day provide of donepezil (Aricept) in capsule kind is lined by Medicare.
Tablets for Alzheimer’s
Rivastigmine (Exelon) and galantamine (Razadyne) can be found in capsule kind, which implies the remedy is enclosed in a shell. Donepezil (Aricept), galantamine (Razadyne) and memantine (Namenda) can be found in pill kind consisting of a powdered type of the drug which is compressed right into a spherical or oval form.
Listed below are the principle variations between capsule and pill kinds:
- Tablets could be damaged in half, or dissolved making them simpler to swallow
- Capsules are faster-acting and trigger much less irritation to the intestine
Professionals
Each tablets and drugs are secure and efficient for symptom administration and are additionally lined by Medicare.
Cons
In comparison with different types of remedy, caregivers say drugs include probably the most drawbacks. Since many individuals with Alzheimer’s have bother swallowing or just refuse to take their drugs. In on-line boards, the place caregivers commerce recommendation for the best way to take care of Alzheimer’s therapies and get the very best outcomes, suggestions shared embrace crushing up tablets and mixing them with applesauce, pudding or one other deal with to make them simpler to swallow.
In these instances, the capsule type of these medication could take longer to manage.
Tablets additionally should be administered each single day. Individuals in delicate levels of Alzheimer’s could have bother remembering to take their day by day dose. For individuals in later levels, caregivers should be readily available to manage therapy daily on the identical time — a heavier raise than a once-weekly pores and skin patch.
Oral Options for Alzheimer’s
Oral options are additionally out there for the medication donepezil (Aricept), galantamine (Razadyne) and memantine (Namenda).
The liquid answer is withdrawn from its container by way of syringe and both expelled right into a glass of water or instantly into the mouth.
Professionals
The oral answer is secure and efficient, simple to swallow. All three present manufacturers are lined by Medicare. This selection could also be an excellent match if a affected person has bother swallowing, is within the later levels of the illness, or prefers liquid over drugs.
Cons
This methodology requires a syringe to attract in fluid from a bottle. It might be troublesome for some sufferers and caregivers to measure out the suitable dose.
Discovering the very best therapy possibility for you
Selecting out the suitable therapy possibility is a vital resolution that you must talk about along with your physician. Despite the fact that all of those medication are efficient, there are benefits and drawbacks to every of the codecs. The precise therapy would be the one that’s most handy and efficient for you and your loved ones.
