Galantamine Dosage
This dosage information may not include all the information needed to use Galantamine safely and effectively. See additional information for Galantamine.
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Alzheimer's Disease
Immediate Release:
Initial dose: 4 mg orally twice a day, preferably with morning and evening meals.
After a minimum of four weeks of treatment, if the initial dosage is well tolerated, it should be increased to 8 mg twice a day. A further increase to 12 mg twice a day should be attempted only after a minimum of 4 weeks at the previous dosage.
If therapy has been interrupted for several days or longer, the patient should be restarted at the lowest dosage. Treatment may then be escalated back up to the dosage the patient was receiving when therapy was interrupted.
The dosage of galantamine shown to be effective in controlled clinical trials is 8 to 16 mg twice daily. However, the dosage at the upper end is less well tolerated than lower ones and does not yield improved efficacy, thus the recommended dose range is 8 to 12 mg twice a day. The 12 mg twice a day dosage was not associated with a statistically significant clinical improvement over the lower dosage in clinical studies but may offer additional benefit for some patients.
Extended Release Capsules:
Initial dose: 8 mg orally daily, preferably with the morning meal.
After a minimum of four weeks of treatment, if the initial dosage is well tolerated, it should be increased to 16 mg once a day. A further increase to 24 mg once a day should be attempted only after a minimum of 4 weeks at the previous dosage. Dose increases should be based upon assessment of clinical benefit and tolerability of the previous dose.
If therapy has been interrupted for several days or longer, the patient should be restarted at the lowest dosage. Treatment may then be escalated back up to the dosage the patient was receiving when therapy was interrupted.
Renal Dose Adjustments
Moderate renal impairment: The dose should generally not exceed 16 mg/day.
Severe renal impairment (CrCl less than 9 mL/min): The use of galantamine is not recommended.
Liver Dose Adjustments
Moderately Impaired Hepatic Function (Child-Pugh score of 7 to 9): The dose should generally not exceed 16 mg/day.
Severe Hepatic Impairment (Child-Pugh score of 10 to 15): The use of galantamine is not recommended.
Precautions
Galantamine has vagotonic effects on the sinoatrial and atrioventricular nodes, which may result in bradycardia and AV block.
Patients treated with galantamine up to 24 mg/day using the recommended dosing schedule showed a dose-related increase in risk of syncope.
Cholinomimetics may be expected to increase gastric acid secretion due to increased cholinergic activity.
Cholinomimetics may cause bladder outflow obstruction.
Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).
Dialysis
Data not available
Other Comments
The abrupt withdrawal of galantamine in patients receiving doses in the effective range was not associated with an increased frequency of adverse events in comparison with those continuing to receive the same doses of that drug.
The beneficial effects of galantamine are lost when the drug is discontinued.
