Formulary
Memantine hydrochloride: Indications, Dosing, Side Effects and Interactions
Memantine is a glutamate receptor antagonist.
MedNext Academy | 3 min read
Memantine hydrochloride: Indications, Dosing, Side Effects and Interactions
Memantine is a glutamate receptor antagonist.
Drug action
Memantine is a glutamate receptor antagonist.
Indications and dose
**Moderate to severe dementia in Alzheimer's disease**
- **Adult** (By Mouth): Initially 5 mg once daily, then increased in steps of 5 mg every week; usual maintenance 20 mg daily; maximum 20 mg per day.
**Oscillopsia in multiple sclerosis**
- **Adult** (By Mouth): Initially 10 mg daily, then increased to 40 mg daily, over 1 week; increased if necessary to 60 mg daily, over 1 week, on specialist advice only.
Cautions
Epilepsy; history of convulsions; risk factors for epilepsy
Side effects
Common or very common Balance impaired; constipation; dizziness; drowsiness; dyspnoea; headache; hypersensitivity; hypertension Uncommon Confusion; embolism and thrombosis; fatigue; fungal infection; hallucination; heart failure; vomiting Rare or very rare Seizure Frequency not known Hepatitis; pancreatitis; psychotic disorder
Interactions
**Other interactions (7):**
- Concomitant administration of memantine with the antispasmodic agents, dantrolene or baclofen, can modify their effects and a dose adjustment may be necessary.
- The same may be true for ketamine and dextromethorphan (see also section 4.4).
- There is one published case report on a possible risk also for the combination of memantine and phenytoin.
- Although no causal relationship has been established, close monitoring of prothrombin time or INR is advisable for patients concomitantly treated with oral anticoagulants.
- In single-dose pharmacokinetic (PK) studies in young healthy subjects, no relevant active substance-active substance interaction of memantine with glyburide/metformin or donepezil was observed.
- In a clinical study in young healthy subjects, no relevant effect of memantine on the pharmacokinetics of galantamine was observed.
Pregnancy
Manufacturer advises avoid unless essential-no information available.
Breast feeding
Manufacturer advises avoid-no information available.
Hepatic impairment
Manufacturer advises avoid in severe impairment-no information available.
Renal impairment
Avoid if eGFR less than 5 mL/minute/1.73 m 2 . Dose adjustments Reduce dose to 10 mg daily if eGFR 30-49 mL/minute/1.73 m 2 , if well tolerated after at least 7 days dose can be increased in steps to 20 mg daily; reduce dose to 10 mg daily if eGFR 5-29 mL/minute/1.73 m 2 .
Medicinal forms
Tablet,Tablet,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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