Australia. The increased cholinergic activity seen with cholinesterase inhibitors may have vagal effects on heart rate (HR), including bradycardia. The Australian Adverse Drug Reactions Advisory Committee (ADRAC) has received a number of reports of cardiac arrhythmias in association with the cholinesterase inhibitors donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl), which are increasingly used for Alzheimer's disease (see table).
ADRAC reports of cholinesterase inhibitor-associated arrhythmia |
| |
Donepezil |
Rivastigmine |
Galantamine |
Bradycardia |
14 |
7 |
6 |
Bundle branch block |
1 |
- |
1 |
AV block |
5 |
- |
1 |
Syncope |
10 |
8 |
4 |
Unspecified arrhythmia |
2 |
- |
1 |
MI/cardiac arrest |
7 |
1 |
- |
Reference:
Australian Adverse Drug Reactions Bulletin, Vol. 23, No.5, October 2004. Available on the Internet at www.tga.gov.au