Galantamine

Introduction: Galantamine is used to treat mild to moderate dementia in Alzheimer's disease, a progressive illness which gradually affects memory and thinking. It does not cure this illness but may help improve memory, awareness and other symptoms.

How it works: Galantamine is a centrally-acting cholinesterase inhibitor that elevates acetylcholine in the cerebral cortex. It works by increasing the levels of a chemical messenger (acetylcholine) involved in transmission of nerve signals, which improves memory and thinking.

Important Information: Your doctor will explain how to take Galantamine and give you the one most suitable for you. It can take up to few weeks for symptoms to improve so keep taking your medicine regularly. Do not stop taking this medicine without consulting your doctor.

• Mild to moderate dementia in Alzheimer's disease

Adjunct anti-epileptic drugs

Cholinesterase inhibitor

Galantamine is a centrally-acting cholinesterase inhibitor, elevating acetylcholine in the cerebral cortex. Glutamine and serotonin levels may also be increased. It has nicotinic receptor agonist properties.

Galantamine inhibits acetylcholinesterase enzyme to increase acetylcholine levels in the synaptic cleft, thereby improving nerve signal transmission and enhancing memory and thinking.

Adult Dose (Alzheimer's Disease):

• Initial: 4 mg twice daily
• Maintenance: Titrate to 8-12 mg twice daily
• Increase by 4 mg twice daily at no less than 4 week intervals

Hepatic Impairment (Moderate):

• Not to exceed 16 mg/day
• Severe: Not recommended

Renal Impairment (Moderate):

• Not to exceed 16 mg/day
• Severe (CrCl <9 mL/min): Not recommended

Children: Not recommended.

* Use as directed by the registered physician

Oral tablet. Take with food (preferably at night before going to bed). Swallow whole, do not chew or crush.

If you miss a dose, skip it and continue with your normal schedule. Do not double the dose.

Common Side Effects:

• Diarrhea
• Nausea
• Vomiting
• Loss of appetite
• Weight loss
• Dizziness
• Increased blood pressure
• Decreased heart rate

Precautions:

• Slows down the progression of Alzheimer's disease - does not cure it.
• Diarrhea, nausea and vomiting may occur - drink plenty of fluids.
• Monitor body weight regularly (weight loss may occur).
• Do not drive or do anything requiring mental focus until you know how it affects you.
• Stop taking and inform your doctor if you notice a skin rash.
• Caution in patients with peptic ulcer (may cause vomiting, stomach bleeding, pain).

Contraindications:

• Hypersensitivity
• Severe liver or kidney dysfunction
• Lactation
• Disorders of galactose metabolism
• Urinary retention or GI obstruction

Drug Interactions:

• CYP2D6 inhibitors (quinidine, fluoxetine, fluvoxamine, paroxetine) and CYP3A4 inhibitors (ketoconazole, ritonavir) increase serum concentrations.
• Cimetidine may increase bioavailability.
• Increased risk of gastric ulcer with NSAIDs.

Food Interactions:

• Unsafe to consume alcohol with Galantamine.

Use in Pregnancy: Generally considered safe during pregnancy. Animal studies have shown low or no adverse effects to the developing baby.

Use in Lactation: Probably unsafe during breastfeeding. Limited data suggests the drug may pass into breastmilk and harm the baby.

Pediatric Use: Not recommended in children.

Geriatric Use: No specific dosage adjustment is necessary for elderly patients. Use with caution.

Renal Impairment: Use with caution in severe kidney disease. Dose adjustment may be needed. Not recommended in end-stage kidney disease.

Hepatic Impairment: Use with caution in liver disease. Dose adjustment may be needed. Not recommended in severe liver disease.

Overdose: Overdose may cause nausea, vomiting, diarrhea, bradycardia, convulsions. Gastric lavage and supportive care.

Storage: Store below 25°C, in a dry place, away from light. Keep out of reach of children.

Galantamine Tablet