Memantine Hydrochloride (Agent for Alzheimer's Dementia)

Question 1

What is the brand name of Memantine hydrochloride?

Answer 1

Namenda

Question 2

What tablet strengths are available for memantine hydrochloride?

Answer 2

5 mg and 10 mg

Question 3

What strengths of extended release capsules are available for memantine hydrochloride?

Answer 3

7 mg, 14 mg, 21 mg, and 28 mg

Question 4

What strength of oral solution is available for memantine hydrochloride?

Answer 4

2 mg/mL (alcohol free, sugar-free)

Question 5

What is the FDA approved indication and dosage for Namenda?

Answer 5

For the treatment of moderate to severe dementia of the Alzheimer’s type.

Tablets & Solution: The recommended starting dose is 5 mg once daily for one week. Increase to 5 mg given twice a day for one week. Increase to 5 mg in the morning and 10 mg in the evening for one week. Finally increase dose to 10 mg twice a day. The recommended target dose is 20 mg per day.

Capsules: Start with 7 mg once daily and titrate up to 28 mg once daily. A minimum of seven days should be observed with a previous test before increasing to the next higher dose.

Question 6

What is the mechanism of action of Namenda?

Answer 6

Persistent activation of CNS N-methyl-D-aspartate (NMDA) receptors by the excitatory amino acid glutamate has been hypothesized to contribute to the symptomology of Alzheimer’s disease. Memantine is thought to exert its therapeutic effect through its action as a low to moderate affinity uncompetitive NMDA receptor antagonist.

Question 7

What are the drug interactions of Namenda?

Answer 7

Drugs that alkalinize the urine (Carbonic anhydrase inhibitor’s or sodium bicarbonate) would be expected to reduce the renal elimination of memantine.

Question 8

What are the contra indications of Namenda?

Answer 8

• Contraindicated in patients hypersensitive to any component of this drug.
• Use with caution in patients with mild, moderate, severe renal impairment.
• Daily doses above 5 mg should not be given twice a day and dose increase it should not be made sooner than once a week.
• Pregnancy Category B

Question 9

What are the adverse effects of Namenda?

Answer 9

The most common adverse effects include dizziness, headache, confusion, hypertension, pain, fatigue, vomiting, coughing, hallucination, and somnolence.

Question 10

What should the RPh tell the patient when counseling for Namenda?

Answer 10

• May be taken with or without food.

- If a dose is missed, skip it and return to normal dosing schedule. Do not double doses.