From: Current pharmacologic options for patients with Alzheimer's disease
AChEI (Binding) | Mechanism of Action | Dosing Schedule | Recommended Daily Dosage Range | Half-life | Comments |
---|---|---|---|---|---|
Tacrine (Non-competitive, reversible) | Inhibition of AChE Inhibition of BuChE | 4 times daily | 120–160 mg/day (Initial dose 40 mg/day) | 3–5 hours | Used in the United States as a last-line agent due to its short half-life and high incidence of hepatotoxicity |
Donepezil (Non-competitive reversible) | Inhibition of AChE | Once daily | 5–10 mg/day (Initial dose 5 mg/day) | 70 hours | Well tolerated, with positive effects on cognition, global function, and ADL |
Rivastigmine (Non-competitive, reversible) | Inhibition of AChE Inhibition of BuChE | Twice daily | 6–12 mg/day (Initial dose 3 mg/day) | 1.5 hours | Well tolerated, with positive effects on cognition, global function, and ADL |
Galantamine (Competitive, reversible) | Inhibition of AChE Allosteric modulation of nicotinic acetylcholine receptors | Twice daily | 16–24 mg/day (Initial dose 8 mg/day) | 7 hours | Well tolerated, with positive effects on cognition, global function, ADL, behavior, and caregiver time |