Alzheimer's Drug Dosing

Question 1

Donepezil

Answer 1

5 mg po daily QHS
- increased to 10 mg po QHS after 4-6 weeks

Question 2

Rivastigmine

Answer 2

Oral: 1.5 mg BID with meals x 2 weeks
- increase by 1.5 mg BID every 2 weeks

Patch: 4.6 mg patch q24hrs
- increase to 9.6 mg every 4 weeks

Question 3

Galantamine

Answer 3

IR: 4 mg BID x 4 weeks with breakfast and dinner
- increased by 8 mg every 4 weeks

ER: 8 mg QD x 4 weeks
- increased by 8 mg every 4 weeks

> 16 mg/day is not recommended in renal/hepatic impairment

Question 4

Memantine

Answer 4

IR: 5 mg QD x 1 week –> 5 mg BID x 1 week –> 5 mg in morning + 10 mg in evening x 1 week –> 10 mg BID

LA: 7 mg QD x 1 week –> 14 mg QD x 1 week –> 21 mg QD x 1 week –> 28 mg QD x 1 week

CrCl < 30 mL/min: 5 mg QD x 1 week –> 5 mg BID

Question 5

Memantine + Donepezil (Namzaric)

Answer 5

Donepezil 10mg:
- 7/10 mg QD
- increased by 7 mg to 28/10 mg

Memantine 10mg BID:
- 28/10 mg QD with meal