Indications for: NAMZARIC
Moderate-to-severe dementia of the Alzheimer's type in patients stabilized on 10mg of donepezil HCl once daily.
Swallow whole or may open caps and sprinkle on applesauce, then consume entire contents; do not divide doses. Patients stabilized on donepezil HCl 10mg: initially 7mg/10mg once daily in the PM; increase at minimum weekly intervals in 7mg increments of memantine HCl to max maintenance dose of 28mg/10mg once daily; severe renal impairment (CrCl 5–29mL/min): initially 7mg/10mg once daily in the PM; increase to maintenance dose of 14mg/10mg once daily after one week. Patients stabilized on both components: 28mg/10mg once daily in the PM. Start the day after last dose of memantine HCl and donepezil HCl given separately. Severe renal impairment (CrCl 5–29mL/min): 14mg/10mg once daily.
Cardiac conduction abnormalities. Peptic ulcer. Monitor for GI bleeding. GU obstruction. Alkalinized urine (eg, renal tubular acidosis, severe UTI) increases memantine levels. Seizures. Asthma or COPD. Severe hepatic impairment. Pregnancy. Nursing mothers.
NMDA receptor antagonist + acetylcholinesterase inhibitor.
Caution with other NMDA antagonists (eg, amantadine, ketamine, dextromethorphan). Memantine plasma levels may be increased by urinary alkalinizers. Donepezil potentiated by CYP3A4 (eg, ketoconazole) and CYP2D6 (eg, quinidine) inhibitors. CYP3A4 inducers (eg, phenytoin, carbamazepine, dexamethasone, rifampin, phenobarbital) may increase the rate of elimination of donepezil. Antagonizes anticholinergics. Additive effects with succinylcholine-type muscle relaxants (during anesthesia), other cholinesterase inhibitors, cholinergic agonists (eg, bethanechol). Concomitant NSAIDs may increase risk of GI bleed.
Headache, diarrhea, dizziness, anorexia, vomiting, nausea, ecchymosis.
Renal. Half-life: 60–80 hours (memantine); ~70 hours (donepezil).
Generic Drug Availability:
Caps 7mg/10mg, 21mg/10mg—30; 14mg/10mg, 28mg/10mg—30, 90