Generic
Memantine + Donepezil
11 brands available in the market
At a glance
Memantine + Donepezil is used for the treatment of moderate to severe dementia of the Alzheimer's type. Memantine acts as an NMDA receptor antagonist and Donepezil acts as an acetylcholinesterase inhibitor.
Description
Memantine + Donepezil contains two approved medications: memantine hydrochloride (extended-release) and donepezil hydrochloride (immediate-release). Memantine is a low to moderate affinity uncompetitive NMDA receptor antagonist that binds preferentially to NMDA receptor-operated cation channels. Donepezil enhances cholinergic function by increasing acetylcholine concentration through reversible inhibition of its hydrolysis by acetylcholinesterase.
Indications
- Moderate to severe dementia of the Alzheimer's type (patients stabilized on donepezil 10 mg once daily)
Therapeutic class
Anti-Alzheimer Drugs
Pharmacological class
NMDA Receptor Antagonist + Acetylcholinesterase Inhibitor
Pharmacology
Memantine reduces glutamate-induced excitotoxicity by blocking NMDA receptors; Donepezil enhances cholinergic neurotransmission by inhibiting acetylcholine breakdown.
Mechanism of action
Regulates neurotransmitter balance in the brain to improve Alzheimer's symptoms.
Dosage
Adult Dose (Oral):
- On donepezil 10 mg only: Initial 7/10 mg in the evening; increase by 7 mg weekly to maintenance 28/10 mg
- On memantine (28 mg ER) + donepezil 10 mg: 28/10 mg in the evening
- Severe renal impairment: Maintenance 14/10 mg in the evening
Administration
- Swallow capsules whole or sprinkle on applesauce
- Do not divide, chew, or crush
- Take once daily in the evening at the same time
Missed dose
Not generally applicable (regular dosing required); consult doctor if needed.
Side effects
Common Side Effects (≥5%):
- Headache
- Diarrhea
- Dizziness
- Anorexia
- Nausea, vomiting
- Ecchymosis
Precautions & warnings
- May exaggerate succinylcholine-type muscle relaxation during anesthesia
- Vagotonic effects on sinoatrial and atrioventricular nodes (bradycardia or heart block)
- Monitor for gastrointestinal bleeding
- May cause bladder outflow obstruction
- Elevated urine pH decreases memantine elimination
Contraindications
- Hypersensitivity to memantine hydrochloride, donepezil hydrochloride, piperidine derivatives, or excipients
Drug interactions
- Use with caution with NMDA antagonists
- May interfere with anticholinergic medications
- Synergistic effect with succinylcholine and cholinergic agonists
Food interactions
Safety with alcohol is not known; consult your doctor.
Use in pregnancy
Use in Pregnancy: No adequate data in pregnant women; use only if clearly needed.
Use in lactation
Use in Lactation: No data on presence in human milk; caution is advised.
Pediatric use
Safety and effectiveness not established in pediatric patients.
Geriatric use
No dose adjustment needed in elderly.
Renal / hepatic impairment
Renal Impairment: Mild-moderate: no dose adjustment; severe: 14/10 mg in the evening.
Hepatic Impairment: Mild-moderate: no dose adjustment; severe: not studied.
Overdose effects
No specific overdose information available; symptomatic and supportive treatment.
Storage conditions
Store below 30°C, away from light and moisture; keep out of reach of children.
Chemical structure
Memantine + Donepezil