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Rhinorrhea as a Result of Alzheimer's Disease Treatment: A Case Report

Donna Bartlett, Michael Bear

    The Senior Care Pharmacist
    |December 11, 2019
    PubMed

    Insights

    Persistent rhinorrhea caused by donepezil, a medication for Alzheimer's disease (AD), was effectively managed with azelastine nasal spray. This case highlights azelastine as a potential treatment for this specific donepezil side effect.

    Area of Science:

    • Pharmacology
    • Neurology
    • Otolaryngology

    Background:

    • Donepezil is a common treatment for Alzheimer's disease (AD).
    • Rhinorrhea, or runny nose, can be an adverse effect of donepezil treatment.
    • This cholinergic side effect is often mistaken for allergic rhinitis.

    Observation:

    • An 84-year-old male patient on donepezil for AD developed persistent rhinorrhea.
    • Oral antihistamines were ineffective in alleviating the patient's symptoms.
    • Azelastine 0.1% nasal spray was administered to manage the rhinorrhea.

    Findings:

    • Azelastine nasal spray successfully resolved the donepezil-induced rhinorrhea.
    • This suggests azelastine can be an effective treatment for this specific adverse drug reaction.
    • No previous literature has recommended azelastine for managing donepezil-induced rhinorrhea in AD patients.

    Implications:

    • Rhinorrhea from donepezil treatment should be considered a cholinergic side effect, not an allergy.
    • Azelastine nasal spray offers a targeted treatment option for this condition.
    • Patients and caregivers should be informed about potential epistaxis with azelastine, especially if on antithrombotic therapy.

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