Beware- Alzheimer drug Donepezil linked to development of Rhabdomyolysis

Alzheimer’s disease is the most common type of dementia that progresses slowly and gets worse over time. Dementia is a growing problem, with almost 10 million newly diagnosed cases every year around the world.

Donepezil is used to treat dementia-related to Alzheimer's disease. It is an enzyme blocker that works by restoring the balance of neurotransmitters in the brain. The drug does not cure Alzheimer's disease, but it may improve memory, awareness, and the ability to function. Researchers at Western University's Schulich School of Medicine & Dentistry and Lawson Health Research Institute have found that donepezil is associated with rhabdomyolysis, a painful condition of muscle breakdown. The study published in CMAJ (Canadian Medical Association Journal) has found a two-fold higher risk of hospital admission because of rhabdomyolysis.

About 26,000 cases of rhabdomyolysis are reported in the United States each year. Rhabdomyolysis is a serious syndrome due to direct or indirect muscle injury. Muscle breakdown causes the release of myoglobin into the bloodstream. This can lead to serious complications such as kidney disease including kidney failure. Some people may require dialysis or hemofiltration to address kidney damage in more severe cases.

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.

"The findings of this population-based cohort study support regulatory agency warnings about the risk of donepezil-induced rhabdomyolysis," writes Dr Jamie Fleet, a postgraduate year 4 resident in physical medicine and rehabilitation now at McMaster University, Hamilton, Ontario, with coauthors. "Reassuringly, the 30-day incidence of hospital admission with rhabdomyolysis after initiating donepezil remains low.

"Risk of rhabdomyolysis with donepezil compared with rivastigmine or galantamine: a population-based cohort study".