memantine


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memantine

Ebixa (CA) (UK), Namenda

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

Therapeutic class: Anti-Alzheimer's agent

Pregnancy risk category B

Action

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.)

Availability

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

Contraindications

• Hypersensitivity to drug or its components

Precautions

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

Administration

• 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

Interactions

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.

memantine

(mə-măn′tēn)
n.
A drug, C20H24N5O4, used in its hydrochloride form to treat symptoms of Alzheimer's disease by inhibiting NMDA receptors.

memantine

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.

memantine

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.

memantine

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 ?
India-based multinational pharmaceutical firm Zydus Cadila has been granted final approval from the US Food and Drug Administration (FDA) to commercialise Memantine Hydrochloride tablets in the United States, its listed entity Cadila Healthcare (NSE: CADILHC) reported on Wednesday.
In this study, 63 patients with fibromyalgia were randomized to 20 mg/day of memantine or matching placebo for a total of 6 months, including an initial 1-month up-titration period.
Reddy's memantine hydrochloride tablets USP, 5 mg, are available in a bottle count size of 60, and the memantine hydrochloride tablets USP, 10 mg, are available in bottle count sizes of 60 and 500.
The first randomized patients to 10 mg memantine or placebo plus donepezil.
That is where the Alzheimer's drug memantine comes in.
Lead scientist Prof Pietro Cottone said: "We found memantine blocks binge eating of junk food.
Objective: To evaluate the effect of Memantine on cognitive functions and level of dependency of patients with Alzheimer dementia.
NAMENDA XR is contraindicated in patients with known hypersensitivity to memantine hydrochloride or to any excipients used in the formulation.
While vitamin E and memantine have known benefits for those with moderately severe Alzheimer's disease (AD), the effects on mild to moderate AD have been limited.
Researchers from Minneapolis VA Health Care System and Icahn School of Medicine at Mount Sinai examined the effectiveness and safety of vitamin E, the drug called memantine, and the combination for treatment of functional decline in patients with mild to moderate AD, Xinhua News reported.
Another subgroup of 140 subjects received the vitamin E capsule and a memantine placebo, while 142 were given a placebo vitamin E capsule and memantine.
of the Minneapolis VA Health Care System, and colleagues examined the effectiveness and safety of vitamin E, memantine, and the combination for treatment of functional decline in patients with mild to moderate AD who were taking an acetylcholinesterase inhibitor (a chemical that increases the level and duration of action of the neurotransmitter acetylcholine).