Reminyl


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Related to Reminyl: Galantamine

galantamine hydrobromide

Razadyne, Razadyne ER, Reminyl (UK), Reminyl XL (CA) (UK)

Pharmacologic class: Cholinesterase inhibitor

Therapeutic class: Anti-Alzheimer's agent

Pregnancy risk category B

Action

Unclear. May reversibly inhibit acetylcholinesterase, increasing concentration of acetylcholine (necessary for nerve impulse transmission) in brain synapses.

Availability

Capsules (extended-release): 8 mg, 16 mg, 24 mg

Oral solution: 4 mg/ml

Tablets: 4 mg, 8 mg, 12 mg

Indications and dosages

Mild to moderate dementia of Alzheimer's disease

Adults: Initially, 4 mg P.O. b.i.d. If patient tolerates dosage well after at least 4 weeks of therapy, increase to 8 mg P.O. b.i.d. May increase to 12 mg P.O. b.i.d. after at least 4 weeks at previous dosage. Recommended range is 16 to 24 mg daily in two divided doses. Or initially, 8 mg P.O. daily (Razadyne ER). If patient tolerates dosage after at least 4 weeks, increase to 16 mg P.O. daily. Further increase to 24 mg P.O. daily should be attempted after minimum of 4 weeks at 16 mg/day.

Dosage adjustment

• Moderate hepatic or renal impairment

Off-label uses

• Vascular dementia

Contraindications

• Hypersensitivity to drug

• Severe hepatic or renal impairment

• Pregnancy or breastfeeding

• Children

Precautions

Use cautiously in:

• asthma, chronic obstructive pulmonary disease, GI bleeding, moderate hepatic or renal impairment, Parkinson's disease, seizures.

Administration

• Before giving, make sure patient is well hydrated, to minimize GI upset.

• Give with morning and evening meals.

• Give with antiemetics as needed.

• Use pipette to add oral solution to beverage; have patient drink it right away.

Adverse reactions

CNS: depression, dizziness, headache, tremor, insomnia, drowsiness, fatigue, syncope

CV: bradycardia

EENT: rhinitis

GI: nausea, vomiting, diarrhea, abdominal pain, dyspepsia, anorexia

GU: urinary tract infection, hematuria

Hematologic: anemia

Other: weight loss

Interactions

Drug-drug Anticholinergics: antagonism of anticholinergic activity

Cholinergics: synergistic effects

Cimetidine, erythromycin, ketoconazole, paroxetine: increased galantamine bioavailability

Patient monitoring

• Assess fluid intake and output to ensure adequate hydration, which helps reduce GI upset.

• Monitor cognitive status.

• Evaluate patient for cardiac conduction abnormalities. Assess pulse regularly for bradycardia.

• Observe for bleeding tendencies.

Assess for depression and suicidal ideation.

Patient teaching

• Instruct caregiver in proper technique for using oral pipette.

• Teach caregiver how to measure patient's pulse. Tell him to report slow pulse right away.

• Recommend frequent, small servings of healthy food and adequate fluids to minimize GI upset.

Tell patient or caregiver to watch for and report signs and symptoms of depression.

• Advise patient or caregiver to establish effective bedtime routine.

• Caution caregiver to prevent patient from performing hazardous activities until adverse reactions are known.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.

Reminyl®  

1. Sabeluzole, see there.
2. Galanthamine.
References in periodicals archive ?
Galantamine (Reminyl): Used for more severe forms of dementia, the side-effect profile is similar as above.
These drugs include donepezil (Aricept), rivastigmine (Exelon), galantamine (Reminyl or Razadyne), and memantine (Namenda).
Next year, Maciw noted, an even larger number of key products, including Nexium, Diovan/ HCT, Avapro, Atacand, Singulair, Avalide, Nasonex, Avandia, Reminyl ER, Taxatore, Strattera, and Zomig/R will all come off patent, representing some $2.3 billion in sales.
(263) IHS GLOBAL INSIGHT, NICE Recommends Alzheimer's Drugs Aricept, Reminyl, Exelon, and Ebixa Following Review (2010), http://www.ihsglobalinsight.corn/SDA/SDADetail19338.htm (last visited Apr.
In March this year, the National Institute for Health and Clinical Excellence (Nice) issued new guidance recommending that people with Alzheimer's in the mild to moderate stages of the disease should be given treatment with Aricept (donepezil), Reminyl (galantamine) or Exelon (rivastigmine).
Some Welsh sheep farmers, who no longer feel that hill farming has a commercial or viable future, have now turned their hand to growing daffodils as an alternative source of the drug as generic manufacturers seek to develop and market an off-patent version of Reminyl. The market is currently worth approximately $8 billion and the occurrence of Alzheimer's is increasing at an alarming rate.
said it has begun sales in Japan of Reminyl, a drug for the treatment of patients with Alzheimer's-type dementia, supplied by Janssen Pharmaceutical K.K.
On 7 October 2010, NICE issued draft guidance, subject to appeal, recommending that Aricept (donepezil, manufactured by Eisai), Reminyl (galantamine, manufactured by Shire) and Exelon (rivastigmine, manufactured by Novartis) be made available to patients with early to moderate stage Alzheimer's disease.
Nice confirmed that it was extending previous recommendations for the use of three drugs - Donepezil (Aricept, Eisai/Pfizer), galantamine (Reminyl, Shire) and rivastigmine (Exelon, Novartis) - to include mild, as well as moderate Alzheimer's disease.
The National Institute for Health and Clinical Excellence had banned Aricept (donepezil), Reminyl (galantamine) and Exelon (rivastigmine).
Nice published new draft guidance saying that Aricept (donepezil), Reminyl (galantamine) and Exelon (rivastigmine) should be made available to people with mild as well as moderate disease -potentially benefiting thousands of people.
The draft decision is for three drugs, Aricept, Exelon and Reminyl.