Memantine - instructions for use, analogs, reviews and release forms (tablets 10 mg and 20 mg of Akatinol and Kanon, drops for ingestion) of a drug for the treatment of dementia, sclerosis, memory loss in adults, children and pregnancy

In this article, you can read the instructions for using the drug Memantine. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of experts on the use of Memantine in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Memantine in the presence of existing structural analogs.Use to treat dementia, sclerosis, memory loss in adults, children, as well as in pregnancy and lactation.

Memantine - the derivative of adamantane, by chemical structure and pharmacological properties is close to amantadine. Memantine blocks glutamate NMDA receptors (including those in the black substance), thereby reducing the excessive stimulating effect of cortical glutamate neurons on the neostratum, which develops against the background of insufficient isolation of dopamine. At the moment there is no evidence base that shows the ability of the drug to slow or prevent the progressive course of Alzheimer's disease.

Composition

Memantine hydrochloride + excipients.

Pharmacokinetics

Eating does not affect absorption. After oral administration, it is rapidly and completely absorbed (absolute bioavailability of about 100%). Biotransformation: approximately 80% of memantine is in the form of a starting material. The main metabolites in humans are N-3,5-dimethylgludantan, a mixture of isomers 4- and 6-hydroxymemanthine and 1-nitroso-3,5-dimethyl-adamantane. None of these metabolites has pharmacological activity.It is excreted by the kidneys, with an alkaline reaction of urine excretion slows down.

Indications

• dementia of the Alzheimer's type of moderate to severe severity;
• vascular dementia of all severity;
• mixed dementia of all degrees of severity;
• loss of memory, ability to concentrate and ability to learn;
• cerebral and spinal spastic syndrome, for example due to brain damage in early childhood, craniocerebral trauma, multiple sclerosis, paraplegia, stroke.

Forms of release

Tablets coated with 10 mg (Memantine Kanon).

Tablets coated with 10 mg and 20 mg (Memantine Acatinol).

Drops for oral administration (Acatinol Memantine). Sometimes mistakenly called a syrup or solution.

Instructions for use and treatment regimen

Pills

Inside, with food, without chewing, squeezed with enough liquid.

Adults with dementia appointed during the first week of therapy at a dose of 5 mg per day, during the second week - at a dose of 10 mg per day (5 mg twice a day). During the 3rd week - at a dose of 15 mg per day (5 mg and 10 mg per day). The maximum daily dose of 20 mg.

The approximate value of the maintenance dose is 10-20 mg per day.The last dose is recommended in the afternoon

In elderly patients: according to the results of clinical studies, the recommended dose for patients over 65 years of age is 20 mg per day.

Children and adolescents less than 18 years of age are not recommended for taking the drug, due to the lack of data on efficacy and safety for these categories of patients.

Patients with renal pathology:

With a mild degree of renal failure (creatinine clearance 50-80 ml / min), dosage adjustment is not required.

With an average degree of renal failure (creatinine clearance 30-49 ml / min), the dose should be 10 mg per day. In case of good tolerability for at least 7 days of treatment, the dose may be increased to 20 mg per day according to the standard treatment regimen.

With severe renal failure (creatinine clearance 5-29 ml / min), the dose of the drug should not exceed 10 mg per day.

Patients with liver pathology:

With a mild degree of hepatic insufficiency (classes A and B on the Child-Pugh scale): no dosage adjustment of the drug is required.

With severe degree of hepatic insufficiency: the daily dose should not exceed 10 mg.

Drops

Install individually.Begin the treatment recommended with the appointment of minimally effective doses.

Adults with the syndrome of dementia prescribe the drug during the first week of therapy at a dose of up to 5 mg per day, during the second week - in a dose of up to 10 mg per day, during the third week - 15-20 mg per day . If necessary, further weekly increase in the dose of 10 mg to achieve a daily dose of 30 mg.

In the spastic syndrome caused by pathology on the part of the central nervous system, during the first week of treatment, a daily dose of 10 mg, during the second week - 20 mg, during the third week - 20-30 mg. If necessary, further increases in the dose of 10 mg weekly until a daily dose of 60 mg.

The estimated value of the maintenance dose is 10-20 mg per day.

The dose for children older than 1 year is set at a rate of 500 mcg / kg per day.

The daily dose is evenly divided into several doses during the day. The drug should be taken with food, the last dose is recommended to take before dinner.

Side effect

• headache;
• dizziness;
• violation of gait;
• convulsions;
• drowsiness;
• increased intracranial pressure;
• increased fatigue;
• epileptic seizures;
• depression;
• increased excitability;
• sleep disturbance;
• confusion of consciousness;
• hallucinations;
• psychotic reactions;
• hypertension;
• venous thrombosis / thromboembolism;
• heart defects;
• constipation;
• nausea, vomiting;
• pancreatitis;
• upper respiratory tract infection;
• bronchitis;
• influenza-like syndrome;
• urinary tract infections;
• fungal diseases;
• hypersensitivity to the drug;
• general weakness.

Contraindications

• severe renal insufficiency;
• severe hepatic impairment;
• congenital intolerance to galactose;
• deficiency of lactase or syndrome of impaired glucose / galactose absorption;
• pregnancy, lactation;
• children under 18 years (for tablets);
• hypersensitivity.

Application in pregnancy and lactation

The use of Memantine is contraindicated in pregnancy and lactation.

Use in children

The drug in the form of tablets is contraindicated in children and adolescents under 18 years of age.

The dose of drops for children older than 1 year is set at a rate of 500 mcg / kg per day.

special instructions

In patients with Alzheimer's disease, the ability to drive vehicles and manage complex mechanisms is usually impaired in the stage of moderate and severe dementia.

The optimal dose is achieved gradually, with increasing doses every week.

Memantine can cause a change in the reaction rate, so patients receiving treatment on an outpatient basis should be especially careful when driving vehicles or controlling mechanisms.

Drug Interactions

With the simultaneous use with preparations of levodopa, dopamine receptor agonists, m-holinoblokatorami action of the latter can be strengthened.

With simultaneous use with barbiturates, neuroleptics, the effect of the latter may decrease.

When combined, the effect of dantrolene or Baclofen can be altered (enhanced or decreased), so the doses of the drugs should be selected individually.

Avoid simultaneous use with phenytoin, amantadine, Ketamine and dextramethorphan.

Possible an increase in plasma concentrations of cimetidine, procainamide, quinidine, kinin and nicotine while taking with memantine.

It is possible to reduce the concentration of hydrochlorothiazide when taken concomitantly with memantine.

According to the experience of postmarketing use of the drug, individual cases of MHO reduction in patients taking Warfarin simultaneously were recorded.

In pharmacokinetic studies in healthy young volunteers with a single administration of memantine with Metformin or donepezil, no interaction effects were recorded.

Also in such studies, no interaction with galantamine was found.

Analogues of the medicinal product Memantine

Structural analogs for the active substance:

• Acathinol Memantine;
• Alzheim;
• Memanean;
• Memantal;
• Memantine Canon;
• Memantine TL;
• Memantine hydrochloride;
• Mémicar;
• The Memorial;
• Noogeron.

Similar medicines:

Other medicines: