Alzheimer's drug associated with two-fold higher risk of hospitalization for rhabdomyolysis

A drug commonly used to manage symptoms of Alzheimer disease and other dementias -- donepezil -- is associated with a two-fold higher risk of hospital admission for rhabdomyolysis, a painful condition of muscle breakdown, compared with several other cholinesterase inhibitors, found a study in CMAJ (Canadian Medical Association Journal).

Dementia is a growing problem, with almost 10 million newly diagnosed cases every year around the world.

The study, led by researchers at Western University's Schulich School of Medicine & Dentistry and Lawson Health Research Institute, looked at ICES data from 2002 to 2017 on 220 353 patients aged 66 years or older in Ontario, Canada, with a new prescription for donepezil, rivastigmine or galantamine, three cholinesterase inhibitors used to manage dementia and Alzheimer disease.

Researchers found that donepezil was associated with a two-fold higher risk of hospitalization for rhabdomyolysis, a serious condition that can result in kidney disease. The relative risk was small but statistically significant.

The findings of this population-based cohort study support regulatory agency warnings about the risk of donepezil-induced rhabdomyolysis. Reassuringly, the 30-day incidence of a hospital admission with rhabdomyolysis after initiating donepezil remains low.

Dr. Jamie Fleet, postgraduate year 4 resident in physical medicine and rehabilitation now at McMaster University, Hamilton, Ontario, with coauthors

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