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Ebixa (CA) (UK), Namenda

Pharmacologic class: N-methyl-D-aspartate receptor antagonist (NMDA)

Therapeutic class: Anti-Alzheimer's agent

Pregnancy risk category B


Unclear. Thought to act as a low- to moderate-affinity NMDA receptor antagonist, binding to NMDA receptor-operated channels. (Activation of these channels is thought to contribute to Alzheimer's symptoms.)


Oral solution: 2 mg/ml

Tablets: 5 mg, 10 mg

Tablets (titration pack): 28 tablets of 5 mg and 21 tablets of 10 mg

Indications and dosages

Moderate to severe Alzheimer's-type dementia

Adults: Initially, 5 mg P.O. daily. Then titrate at intervals of at least 1 week in 5-mg increments, to a maximum of 10 mg P.O. b.i.d.

Dosage adjustment

• Moderate renal impairment


• Hypersensitivity to drug or its components


Use cautiously in:
• neurologic conditions, moderate to severe renal impairment, genitourinary conditions that increase pH
• pregnant or breastfeeding patients.


• Give with or without food.

Adverse reactions

CNS: dizziness, headache, syncope, aggressive reaction, confusion, somnolence, hallucinations, agitation, insomnia, vertigo, ataxia, abnormal gait, hypokinesia, anxiety, transient ischemic attack, cerebrovascular accident (CVA)

CV: hypertension, cardiac failure

EENT: cataract, conjunctivitis

GI: nausea, vomiting, diarrhea, constipation, anorexia

GU: frequent voiding, urinary incontinence, urinary tract infection

Hematologic: anemia

Musculoskeletal: back pain, arthralgia

Respiratory: cough, dyspnea, bronchitis, pneumonia

Skin: rash

Other: weight loss, fatigue, pain, falls, flulike symptoms, peripheral edema


Drug-drug.Cimetidine, hydrochlorothiazide, nicotine, quinidine, ranitidine, triamterene: altered blood levels of both drugs

Urine-alkalizing drugs (carbonic anhydrase inhibitors, sodium bicarbonate): decreased memantine elimination

Drug-diagnostic tests.Alkaline phosphatase: increased level

Patient monitoring

Check for heart failure and signs and symptoms of CVA.
• Monitor kidney function tests.

Patient teaching

• Tell patient to take with or without food.
• Instruct patient or caregiver not to mix solution with other liquids and to take or give oral solution only with included dosing device.
• Make sure patient or caregiver understands dose escalation.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.


A drug, C20H24N5O4, used in its hydrochloride form to treat symptoms of Alzheimer's disease by inhibiting NMDA receptors.


an anti-Alzheimer agent.
indications This drug is used to treat moderate to severe dementia in Alzheimer's disease.
contraindication Known hypersensitivity to this drug prohibits its use.
adverse effects Adverse effects of this drug include somnolence, headache, hallucinations, hypertension, vomiting, constipation, rash, coughing, dyspnea, back pain, fatigue, and pain. Common side effects include dizziness and confusion.


An NMDA (N-methyl D-aspartate) receptor antagonist that counters the toxic effects of glutamate excess to manage the symptoms of moderate to severe Alzheimer’s disease.

Adverse effects
Hallucinations, confusion, dizziness, headache, hypertonia, nausea, vomiting, constipation, hypertonia, cystitis, increased libido.
Proposed mechanism
Interferes with homocysteine binding at the NMDA receptor; homocysteine also mediates excitotoxicity, and disturbs glutamatergic neurotransmission.


An inhibitor of glutamate NMDA RECEPTORS used with the expectation of delaying the progress of ALZHEIMER'S DISEASE and other forms of dementia. It has been shown to have some value even in the later stages of dementia. A brand name is Ebixa.
References in periodicals archive ?
The court stated that "[a]s long as [d]efendants sought to persuade patients and their doctors to switch from Namenda IR to Namenda XR while both were on the market (the soft switch) and with generic IR drugs on the horizon, patients and doctors could evaluate the products and their generics on the merits in furtherance of competitive objectives.
15) Before Namenda IR was withdrawn from the market, the State of New York filed a complaint seeking an injunction against Actavis in the United States District Court for the Southern District of New York, alleging that the withdrawal of Namenda IR violated antitrust laws because it both effectively forced consumers to switch to Namenda XR, the only other available memantine drug alternative, and impeded generic competition.
In addition, Namenda XR has benefits over earlier drugs.
NAMENDA XR offers important benefits, including convenient, once-daily dosing, which is particularly meaningful for this patient population and their caregivers.
Bystolic and valsartan, Namenda XR and donepezil, Tudorza and formoterol, and Teflaro with avibactam.
Actavis global brands senior vice president David Nicholson said: "Namzaric combines, in one capsule, two complementary therapeutic agents which are often co-prescribed as approximately 70% of Namenda XR patients are also on AChEI therapy.
M2 EQUITYBITES-June 19, 2014-Forest Laboratories acquires extended US market pediatric exclusivity for NAMENDA and NAMENDA XR by six months
M2 PHARMA-June 19, 2014-Forest Laboratories acquires extended US market pediatric exclusivity for NAMENDA and NAMENDA XR by six months
M2 EQUITYBITES-June 11, 2014-Forest Laboratories plans to continue marketing both NAMENDA TABLETS and once-daily NAMENDA XR up to autumn of 2014
M2 PHARMA-June 11, 2014-Forest Laboratories plans to continue marketing both NAMENDA TABLETS and once-daily NAMENDA XR up to autumn of 2014
The two companies have been examining a pill that unites Namenda XR with donepezil, or Aricept.
We also still have Namenda XR, a 28 mg once-daily extended-release formulation of memantine for the treatment of moderate and severe Alzheimer's disease, which has been approved, but not yet launched.