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What Is Memantine Used For

what is memantine used for

What is donepezil and memantine?

Donepezil improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine. People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.

Memantine reduces the actions of chemicals in the brain that may contribute to the symptoms of Alzheimer's disease.

Donepezil and memantine is a combination medicine used to treat moderate to severe dementia of the Alzheimer's type.

Donepezil and memantine is not a cure for Alzheimer's disease. This condition will progress over time, even in people who take donepezil.

Donepezil and memantine may also be used for purposes not listed in this medication guide.

How to use

 Read the Patient Information Leaflet if available from your pharmacist before you start taking memantine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor. The dosage is based on your medical condition and response to treatment. When you first start taking this medication, you will usually take it once daily. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose.

Contraindications / Precautions

General Information

The use of memantine is contraindicated in any patient with a known memantine hypersensitivity or hypersensitivity to any inactive ingredients or excipients contained within the products.

Renal failure, renal impairment, renal tubular acidosis (RTA), urinary tract infection (UTI)

Memantine is predominantly eliminated by the kidneys in part by tubular secretion. Dosage adjustments of memantine are required in patients with severe renal impairment (CrCl less than 30 mL/minute). No data are available for use of memantine in patients with renal failure on dialysis. Use memantine with caution in patients with conditions that could affect urinary pH such as renal tubular acidosis (RTA), severe urinary tract infection (UTI), and renal failure.

Hepatic disease

Memantine undergoes partial hepatic metabolism. Caution is advised when using memantine in those with severe hepatic disease as specific studies of the drug in these patients are not available and the elimination half-life may be prolonged. No dosage adjustments are required in patients with mild to moderate hepatic impairment. 

Geriatric

The majority of people with Alzheimer's disease are 65 years and older; during clinical trials in patients with Alzheimer's dementia, there was no noted differences in adverse effects reported among geriatric patients and those younger than 65 years of age. Geriatric patients may be at greater risk for renal impairment due to age-related changes in renal function, concomitant medications or other risk factors that may influence dosage. The federal Omnibus Budget Reconciliation Act (OBRA) regulates medication use in residents of long-term care facilities (LTCFs). According to OBRA guidelines, the continued use of memantine for the treatment of a cognitive disorder in residents of a LTCF should be re-evaluated as the underlying disorder progresses into advanced stages. Adverse effects of memantine include restlessness, distress, dizziness, somnolence, hypertension, headache, hallucinations, and increased confusion.

Pregnancy

There are no adequate and well-controlled studies in pregnant women. Memantine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. In animal studies in rats and rabbits, memantine was not teratogenic during the period of organogenesis up to the highest doses tested (18 mg/kg/day in rats and 30 mg/kg/day in rabbits, which are 6- and 21-times, respectively, the maximum recommended human dose [MRHD] on a mg/m2 basis). Slight maternal toxicity, decreased pup weights and an increased incidence of non-ossified cervical vertebrae were seen at 18 mg/kg/day orally in a rat study from pre-mating through the postpartum period. Slight maternal toxicity and decreased pup weights were also seen at this dose in rats treated from day 15 of gestation through the post-partum period. The no-effect dose for these effects was 6 mg/kg, which is 2 times the MRHD on a mg/m2 basis. 

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