Drug interactions
Indacaterol-glycopyrronium + Rivastigmine
Severity: Moderate
Indacaterol-glycopyrronium 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 activity, whereas glycopyrronium blocks muscarinic receptors, so the two have opposing pharmacological effects. Inhaled glycopyrronium has low systemic exposure, so the loss of rivastigmine benefit is probably small. Rivastigmine may also add to bronchoconstriction in airway disease.
What this interaction means in plain words
Indacaterol-glycopyrronium 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.
Indacaterol-glycopyrronium belongs to Respiratory; Rivastigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between a cholinesterase inhibitor and a muscarinic antagonist.
What to do
Monitor cognitive response to rivastigmine and respiratory symptoms. Consider whether the anticholinergic is needed if dementia symptoms worsen.
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 Indacaterol-glycopyrronium
Other interactions of Rivastigmine
Frequently asked questions
Can I take Indacaterol-glycopyrronium with Rivastigmine?
MediHelp rates the interaction as moderate. Indacaterol-glycopyrronium 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 activity, whereas glycopyrronium blocks muscarinic receptors, so the two have opposing pharmacological effects. Inhaled glycopyrronium has low systemic exposure, so the loss of rivastigmine benefit is probably small. Rivastigmine may also add to bronchoconstriction in airway disease.
How serious is the interaction between Indacaterol-glycopyrronium 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: Monitor cognitive response to rivastigmine and respiratory symptoms. Consider whether the anticholinergic is needed if dementia symptoms worsen.
What other medicines interact with Indacaterol-glycopyrronium?
MediHelp also lists interactions of Indacaterol-glycopyrronium with, for example, Amisulpride, Arformoterol, Arsenic trioxide. The full list is on the Indacaterol-glycopyrronium page.
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