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 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 ?
Memantine can improve memory, attention, language, and simple task performance, says David Mischoulon, MD, PhD, director of the Depression Clinical and Research Program at Massachusetts General Hospital.
Moreover, the consistency observed in 94% of those patients not taking memantine further supports our current study and underscores the transformative potential of bryostatin as a treatment for AD.'
The magnitude of improvement was greater in a pre-specified exploratory analysis of patients not on memantine therapy (n=16).
Table 3 (page 15) outlines the mechanisms of action and common uses for NAC, memantine, ketamine, topiramate, lamotrigine, and D-cycloserine.
At that time his parents reported that the child of a family friend was involved in a clinical trial assessing use of memantine to increase social expression for patients with ASD and were interested in a trial of memantine for this purpose.
We found this investigation to be highly relevant to broaden our understanding of the role of NMDA receptor dysfunction in the pathogenesis of DS, particularly in light of work showing that memantine can rescue learning and memory deficits in Ts65Dn mice [23-25].
with memantine in patients with moderate to severe Alzheimer's disease: a double-blind randomized clinical trial.
M2 EQUITYBITES-July 12, 2017-Zydus Cadila granted final FDA approval to commercialise Memantine Hydrochloride
M2 PHARMA-July 12, 2017-Zydus Cadila granted final FDA approval to commercialise Memantine Hydrochloride
Among NMDAR antagonist compounds, recently, great emphasis has been placed on memantine, a derivative of amantadine, an anti-influenza agent.