Namenda


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Related to Namenda: Memantine, Exelon

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.

Namenda

(nə-mĕn′də)
A trademark for the drug memantine hydrochloride.

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.
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References in periodicals archive ?
* NAMENDA[R] net revenues in the fourth quarter of 2018 were $10.7 million compared to $97.8 million in the prior year quarter, impacted by loss of patent exclusivity for NAMENDA XR[R] in February 2018.
[Actavis] decided to withdraw virtually all Namenda IR from the market in order to force Alzheimer's patients who depend on Namenda IR to switch to XR before generic IR becomes available.
For intervention, a treatment with a Cholinesterase inhibitor as well as a glutamatergic agent (NMDA receptor antagonist), including Aricept and Namenda, can be used for this form of Alzheimer's disease.
(36) The brand's internal documents in the hearing in the Namenda case discussed below revealed that "if we do the hard switch and [] convert patients and caregivers to once-a-day therapy versus twice a day, it's very difficult for the generics then to reverse-commute back." (37) And a recent empirical review of product hops concluded that "after a patient is on the new drug and the old drug has gone generic, the new brand did not lose share," which was true "regardless of clinical differentiation." (38)
Aricept (donepezil hydrochloride) from Pfizer/Eisais was the world best-selling drug till 2010, which lost patent protection in November 2010 and at present, Namenda (memantine hydrochloride) from Forest Laboratories, Exelon (rivastigmine) from Novartis and Ebixa (memantine) from Lundbeck Ltd.
The company said the Memantine Hydrochloride Tablets USP, 5 mg and 10 mg, is the therapeutic equivalent to the reference listed drug, Namenda Tablets, 5 mg and 10 mg, of Forest Laboratories LLC.
Namenda : Robust Regulatory Analysis, Improper Coercion Focus
In addition, glutamate blockers such as Namenda, SSRIs such as Paxil, and atypical antipsychotics such as Seroquel are frequently used.
Expiry of the blockbuster patented drugs such as Gleevec, Namenda, Provigil, Crestor, Benicar etc.
Allergan, best known for its anti-wrinkle treatment Botox, also makes Alzheimer's drug Namenda and dry-eye medication Restasis.
Pfizer kicked off 2015 by announcing that it would (http://www.pfizer.com/news/press-release/press-release-detail/pfizer_to_acquire_hospira) buy Hospira Inc., which produces injectable drugs and biosimilars, for $17 billion.AaAaAeAeAaAeAeA If this latest purchase is also completed, Pf will welcome brand name specialty drugs including anti-wrinkle Botox injections and Namenda for dementia to its already-expandingAaAaAeAeAaAeAeA portfolio.