Drug interactions
Fesoterodine + Rivastigmine
Severity: Moderate
Fesoterodine and Rivastigmine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Rivastigmine enhances cholinergic transmission while fesoterodine blocks muscarinic receptors, so each can reduce the effect of the other. Cholinesterase inhibitors can also cause urinary urgency or incontinence, and treating it with an antimuscarinic may worsen cognition.
What this interaction means in plain words
Fesoterodine and Rivastigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Fesoterodine belongs to Genitourinary; Rivastigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between a cholinesterase inhibitor and a muscarinic receptor antagonist.
What to do
Avoid routine combination where possible and review whether urinary symptoms are caused by rivastigmine. If used together, monitor cognition and urinary symptoms and consider a non-antimuscarinic option such as mirabegron.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Fesoterodine
Other interactions of Rivastigmine
Frequently asked questions
Can I take Fesoterodine with Rivastigmine?
MediHelp rates the interaction as moderate. Fesoterodine and Rivastigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rivastigmine enhances cholinergic transmission while fesoterodine blocks muscarinic receptors, so each can reduce the effect of the other. Cholinesterase inhibitors can also cause urinary urgency or incontinence, and treating it with an antimuscarinic may worsen cognition.
How serious is the interaction between Fesoterodine and Rivastigmine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid routine combination where possible and review whether urinary symptoms are caused by rivastigmine. If used together, monitor cognition and urinary symptoms and consider a non-antimuscarinic option such as mirabegron.
What other medicines interact with Fesoterodine?
MediHelp also lists interactions of Fesoterodine with, for example, Bethanechol, Clozapine, Levoketoconazole. The full list is on the Fesoterodine page.
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