galantamine (Oral route)

Pronunciation

ga-LAN-ta-meen

Commonly used brand name(s)

In the U.S.

  • Razadyne
  • Razadyne ER
  • Razadyne IR

Available Dosage Forms:

  • Tablet
  • Capsule, Extended Release
  • Solution

Therapeutic Class: Central Nervous System Agent

Pharmacologic Class: Cholinesterase Inhibitor, Centrally/Peripherally Acting

Uses For galantamine

Galantamine is used to treat mild to moderate dementia (memory loss and mental changes) that is a sign of Alzheimer's disease. Galantamine will not cure Alzheimer's disease, and it will not stop the disease from getting worse. However, galantamine can improve the thinking ability in some patients with Alzheimer's disease.

Slideshow: Flashback: FDA Drug Approvals 2013

In Alzheimer's disease, many chemical changes take place in the brain. One of the earliest and biggest changes is that there is less of a chemical called acetylcholine (ACh). ACh helps the brain to work properly. Galantamine slows the breakdown of ACh, so it can build up and have a greater effect. However, as Alzheimer's disease gets worse, there will be less and less ACh, so galantamine may not work as well.

galantamine is available only with your doctor's prescription.

Before Using galantamine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For galantamine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to galantamine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of galantamine in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of galantamine in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking galantamine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using galantamine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Piperaquine

Using galantamine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Clarithromycin
  • Crizotinib
  • Dabrafenib
  • Delamanid
  • Escitalopram
  • Fluoxetine
  • Ivabradine
  • Ondansetron
  • Pazopanib
  • Quetiapine
  • Sevoflurane
  • Vandetanib
  • Vemurafenib
  • Vinflunine

Using galantamine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amitriptyline
  • Fluvoxamine
  • Ketoconazole
  • Oxybutynin
  • Paroxetine
  • Quinidine
  • Tolterodine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of galantamine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Asthma (severe), history of or
  • Lung disease (eg, obstructive pulmonary disease) or
  • Seizures or
  • Stomach bleeding or ulcers, or history of or
  • Urinary bladder blockage—Use with caution. May make these conditions worse.
  • Heart rhythm problems—May increase risk for more serious side effects.
  • Kidney disease, moderate or
  • Liver disease, moderate—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Kidney disease, severe or
  • Liver disease, severe—Use is not recommended in patients with these conditions.

Proper Use of galantamine

Take galantamine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

If you are taking the extended-release capsules:

  • Take it with your morning meal.
  • Swallow the extended-release capsule whole. Do not crush, break, or chew it.

If you are taking the oral liquid:

  • Follow the instruction sheet for the proper dosing of the oral liquid. Ask your doctor or pharmacist if you have any questions.
  • Measure your dose with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

Take the oral liquid or tablets with morning or evening meals.

Drink extra fluids so you will pass more urine while you are using galantamine. This may help prevent kidney problems.

Dosing

The dose of galantamine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of galantamine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For treatment of Alzheimer's disease:
    • For oral dosage form (extended-release capsules):
      • Adults—At first, 8 milligrams (mg) once a day with food. Your doctor may increase your dose to 16 mg per day after at least 4 weeks, and then to 24 mg per day after at least another 4 weeks.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage forms (oral solution or tablets):
      • Adults—At first, 4 milligrams (mg) two times a day. Your doctor may increase your dose to 8 mg two times a day after at least of 4 weeks, and then to 12 mg two times a day after at least 4 weeks.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of galantamine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you missed your dose for more than 3 days, call your doctor right away. You may need to go back to a lower dose.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using galantamine

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to check for unwanted effects.

Galantamine may cause stomach or bowel problems. Check with your doctor right away if you have nausea, vomiting, diarrhea, stomach pain, loss of appetite, or weight loss.

If you think you or someone else may have taken an overdose of galantamine, get emergency help at once. Taking an overdose of galantamine may lead to convulsions (seizures) or shock. Some signs of shock are large pupils, irregular breathing, and fast weak pulse. Other signs of an overdose are severe nausea and vomiting, increasing muscle weakness, greatly increased sweating, and greatly increased watering of the mouth.

Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines, such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.

galantamine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
  • Chest pain or discomfort
  • lightheadedness, dizziness, or fainting
  • shakiness in the legs, arms, hands, or feet
  • shortness of breath
  • slow or irregular heartbeat
  • unusual tiredness
Rare
  • Blurred vision
  • confusion
  • decreased urination
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • dry mouth
  • fainting
  • fast, irregular, pounding, or racing heartbeat or pulse
  • feeling of warmth
  • rapid breathing
  • redness of the face, neck, arms, and occasionally, upper chest
  • sunken eyes
  • sweating
  • thirst
  • troubled breathing
  • unusual tiredness or weakness
  • wrinkled skin
Incidence not known
  • Dark urine
  • fever
  • general tiredness and weakness
  • headache
  • hoarseness
  • irritation
  • joint pain, stiffness, or swelling
  • light-colored stools
  • nausea and vomiting
  • nervousness
  • pounding in the ears
  • rash, hives, or itching skin
  • redness of the skin
  • swelling of the eyelids, face, lips, hands, or feet
  • tightness in the chest
  • troubled swallowing
  • upper right abdominal or stomach pain
  • yellow eyes and skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
  • Confusion
  • convulsions
  • irregular, fast or slow, or shallow breathing
  • muscle weakness
  • pale or blue lips, fingernails, or skin
  • severe nausea
  • stomach cramps
  • sweating
  • tearing of the eyes
  • twitches of the muscle visible under the skin
  • vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Decreased appetite
  • diarrhea
  • weight loss
Less common
  • Acid or sour stomach
  • belching
  • discouragement
  • feeling sad or empty
  • general feeling of discomfort or illness
  • heartburn
  • increased sweating
  • indigestion
  • irritability
  • lack of appetite
  • lack or loss of strength
  • loss of interest or pleasure
  • muscle spasms
  • stomach discomfort, upset, or pain
  • trouble concentrating
  • trouble sleeping
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Rare
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in taste
  • dry heaves
  • loss of taste
  • unusually deep sleep
  • unusually long duration of sleep
Incidence not known
  • Continuing ringing or buzzing or other unexplained noise in the ears
  • hearing loss
  • seeing, hearing, or feeling things that are not there

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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