Memantine Hydrochloride
Description:
Persistent activation of N-methyl-D-aspartate (NMDA) receptors in the Central Nervous System by the excitatory amino acid glutamate has been hypothesized to contribute to the symptomatology of Alzheimer's disease. Memantine is postulated to exert its therapeutic effect through its action as a low to moderate affinity as an uncompetitive (open-channel) NMDA receptor antagonist which binds preferentially to the NMDA receptor-operated cation channels.
Dosage & Administration:
The recommended maintenance dose of Memantine for adults and older patients is 20 mg every day. In order to lower the risk of side effects, the dose should be achieved by upward titration with 5 mg per week over 3 weeks, achieving the maintenance dose of 20 mg/day from the start of week 4 according to the following dosage guideline:
Week 1 (Everyday): Morning- 5 mg (1 tablet), Night- No dose
Week 2 (Everyday): Morning- 5 mg (1 tablet), Night- 5 mg (1 tablet)
Week 3 (Everyday): Morning- 10 mg (2 tablets), Night- 5 mg (1 tablet)
Week 4 and onwards (Everyday): Morning- 10 mg (2 tablets), Night- 10 mg (2 tablets)
Missed Dose: If any dose is missed, just wait and take the next dose at the usual time. Do not double the dose to compensate for the missed dose.
Interaction:
Amantadine, Anticholinergics, Anticonvulsives, Baclofen, Barbiturates, Cimetidine, Dantrolene, Dextromethorphan, Dopaminergic, Hydrochlorothiazide, Ketamine, Neuroleptics, Nicotine, Procainamide, Quinidine, Quinine, Ranitidine.
Contraindications:
Memantine Hydrochloride is contraindicated in patients with known hypersensitivity to Memantine Hydrochloride or to any excipients used in the formulation.
Side Effects:
The most frequent side effects (frequency of 2% or less) include hallucination, confusion, dizziness, headache, and fatigue. Occasional side effects include anxiety, hypertonus (heightened muscle tension), vomiting, bladder infections, and increased sexual drive. If there is a history of epileptic seizures, there is a slight chance that Memantine may increase the probability of an attack.
Pregnancy & Lactation:
Pregnancy Category B. Yet there are no adequate and well-controlled studies of Memantine in pregnant women. Memantine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Memantine is excreted in human breast milk. Because many drugs are excreted in human milk, caution should be exercised when Memantine is administered to a nursing mother.
Precautions & Warnings:
Caregivers should be instructed in the recommended administration (twice per day for doses above 5 mg) and dose escalation (minimum interval of one week between dose increases). If the patients suffer from kidney dysfunction, their kidney function should be monitored on a regular basis.
Neurological Conditions-
Use in Special Populations:
Symptoms: Agitation, asthenia, bradycardia, vomiting, dizziness, vertigo, ECG changes, increased BP, visual hallucinations, confusion, lethargy, restlessness, slowed movement, somnolence, stupor, unsteady gait, weakness, loss of consciousness, psychosis, coma.
Management: Symptomatic and supportive treatment. May increase elimination by urinary acidification.
Storage:
Store in a cool and dry place, protected from light. Keep this medication out of reach of children.
Therapeutic Class: Drugs of Nervous System (Anti-Alzheimer drugs, Drugs for Dementia)
Indications:
Memantine is indicated for the treatment of all forms of dementia of the Alzheimer's type. Memantine may also be indicated in other types of dementia.
Memantine is indicated for the treatment of all forms of dementia of the Alzheimer's type. Memantine may also be indicated in other types of dementia.
Presentation:
Each film-coated tablet contains Memantine Hydrochloride 5 mg.
Each film-coated tablet contains Memantine Hydrochloride 5 mg.
Description:
Persistent activation of N-methyl-D-aspartate (NMDA) receptors in the Central Nervous System by the excitatory amino acid glutamate has been hypothesized to contribute to the symptomatology of Alzheimer's disease. Memantine is postulated to exert its therapeutic effect through its action as a low to moderate affinity as an uncompetitive (open-channel) NMDA receptor antagonist which binds preferentially to the NMDA receptor-operated cation channels.
Dosage & Administration:
The recommended maintenance dose of Memantine for adults and older patients is 20 mg every day. In order to lower the risk of side effects, the dose should be achieved by upward titration with 5 mg per week over 3 weeks, achieving the maintenance dose of 20 mg/day from the start of week 4 according to the following dosage guideline:
Week 1 (Everyday): Morning- 5 mg (1 tablet), Night- No dose
Week 2 (Everyday): Morning- 5 mg (1 tablet), Night- 5 mg (1 tablet)
Week 3 (Everyday): Morning- 10 mg (2 tablets), Night- 5 mg (1 tablet)
Week 4 and onwards (Everyday): Morning- 10 mg (2 tablets), Night- 10 mg (2 tablets)
Missed Dose: If any dose is missed, just wait and take the next dose at the usual time. Do not double the dose to compensate for the missed dose.
Interaction:
Amantadine, Anticholinergics, Anticonvulsives, Baclofen, Barbiturates, Cimetidine, Dantrolene, Dextromethorphan, Dopaminergic, Hydrochlorothiazide, Ketamine, Neuroleptics, Nicotine, Procainamide, Quinidine, Quinine, Ranitidine.
Contraindications:
Memantine Hydrochloride is contraindicated in patients with known hypersensitivity to Memantine Hydrochloride or to any excipients used in the formulation.
Side Effects:
The most frequent side effects (frequency of 2% or less) include hallucination, confusion, dizziness, headache, and fatigue. Occasional side effects include anxiety, hypertonus (heightened muscle tension), vomiting, bladder infections, and increased sexual drive. If there is a history of epileptic seizures, there is a slight chance that Memantine may increase the probability of an attack.
Pregnancy & Lactation:
Pregnancy Category B. Yet there are no adequate and well-controlled studies of Memantine in pregnant women. Memantine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Memantine is excreted in human breast milk. Because many drugs are excreted in human milk, caution should be exercised when Memantine is administered to a nursing mother.
Precautions & Warnings:
Caregivers should be instructed in the recommended administration (twice per day for doses above 5 mg) and dose escalation (minimum interval of one week between dose increases). If the patients suffer from kidney dysfunction, their kidney function should be monitored on a regular basis.
Neurological Conditions-
- Seizures: Memantine has not been systematically evaluated in patients with a seizure disorder. One clinical trial shows that seizures occurred in 0.2% of patients treated with Memantine and 0.5% of patients treated with placebo.
- Carcinogenesis, Mutagenesis, and Impairment of Fertility: The study shows that no risk of carcinogenesis, mutagenesis, and impairment of fertility is caused after Memantine use.
Use in Special Populations:
- In case of renal impairment: A target dose of 5 mg BID is recommended in patients with severe renal impairment (creatinine clearance: 5-29 ml/min).
- In case of hepatic impairment: No dosage adjustment is needed in patients with mild or moderate hepatic impairment. Memantine should be administered with caution to patients with severe hepatic impairment.
Symptoms: Agitation, asthenia, bradycardia, vomiting, dizziness, vertigo, ECG changes, increased BP, visual hallucinations, confusion, lethargy, restlessness, slowed movement, somnolence, stupor, unsteady gait, weakness, loss of consciousness, psychosis, coma.
Management: Symptomatic and supportive treatment. May increase elimination by urinary acidification.
Storage:
Store in a cool and dry place, protected from light. Keep this medication out of reach of children.