Most Read Articles
01 Oct 2013

Heart disease is still New Zealand’s biggest killer, with one Kiwi dying from coronary heart disease every 90 minutes. Pharmacy Today New Zealand looks at how pharmacists can help

Dr. James Salisi, 01 Jul 2014

The recent spike in the number of new cases of human immunodeficiency virus (HIV) infection in the Philippines means that clinicians and pharmacists alike may need to increase their awareness and competency in prescribing and monitoring HIV treatment. Although taught in medical and pharmacy schools, the scarcity in exposure to clinical cases before highlights the need to for physicians and pharmacist to review HIV pharmacotherapy in order to cater to the increasing HIV patient population.

3 days ago
A recent study suggests that discontinuation of dexamethasone premedication after two uneventful infusions or reduction in the dose of dexamethasone paclitaxel premedication are both safe alternatives to high-dose steroid premedications recommended in product labelling.
01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute. 

Tolterodine, solifenacin, oxybutynin use tied to increased risk of dementia

21 Apr 2017

Subsequent dementia is associated with taking tolterodine, solifenacin and particularly oxybutynin in patients with diabetes mellitus, a new study shows.

The study retrieved records of 10,938 patients who had received at least one type of oxybutynin, tolterodine or solifenacin from the Taiwan National Health Insurance Research Database. An age-, sex- and index date-matched control cohort was established on a 1:1 ratio. Those diagnosed with dementia before the index date or within 180 days were excluded.

Comorbidities included in the analysis were hypertension, lipid disorders, atrial fibrillation, chronic kidney diseases, coronary artery disease and heart failure.

Dementia was reported in 7,774 at the end of the follow-up period. For the oxybutynin, solifenacin and tolterodine groups, the 6-year dementia rates were 3.9, 4.3 and 2.2 percent, respectively. These rates were significantly different compared with the control group (1.2 percent; p<0.001).

After age- and sex-matching, only 2,540 patients were eligible for analysis. The 6-year dementia rates for this group decreased for oxybutynin (3.0 percent) and solifenacin (3.5 percent). Interestingly, the rate increased in controls (2.4 percent) to a level that was higher than that reported in tolterodine users (2.3 percent).

According to the failure curve, dementia was significantly more likely to occur in patients who took oxybutynin, solifenacin or tolterodine (p<0.001 for all).

After adjusting for confounders, the competing-risk regression model showed that those who received oxybutynin (adjusted hazard ratio [aHR], 2.35; 95 percent CI, 1.96 to 2.81), solifenacin (aHR, 2.16; 1.81 to 2.58) and tolterodine (aHR, 2.24; 1.85 to 2.73) were at higher risks of dementia, with death as the competing event. Of the three drugs, solifenacin showed the lowest risk.

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Most Read Articles
01 Oct 2013

Heart disease is still New Zealand’s biggest killer, with one Kiwi dying from coronary heart disease every 90 minutes. Pharmacy Today New Zealand looks at how pharmacists can help

Dr. James Salisi, 01 Jul 2014

The recent spike in the number of new cases of human immunodeficiency virus (HIV) infection in the Philippines means that clinicians and pharmacists alike may need to increase their awareness and competency in prescribing and monitoring HIV treatment. Although taught in medical and pharmacy schools, the scarcity in exposure to clinical cases before highlights the need to for physicians and pharmacist to review HIV pharmacotherapy in order to cater to the increasing HIV patient population.

3 days ago
A recent study suggests that discontinuation of dexamethasone premedication after two uneventful infusions or reduction in the dose of dexamethasone paclitaxel premedication are both safe alternatives to high-dose steroid premedications recommended in product labelling.
01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute.