galantamine

Pronunciation

Generic Name: galantamine (ga LAN ta meen)
Brand Name: Razadyne, Razadyne ER, Reminyl

What is galantamine?

Galantamine improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.

Galantamine is used to treat mild to moderate dementia caused by Alzheimer's disease.

Galantamine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about galantamine?

Before taking galantamine, tell your doctor if you have urination problems, heart disease, a heart rhythm disorder, stomach ulcers or bleeding, a seizure disorder, kidney disease, liver disease, or asthma.

Stop using galantamine and call your doctor at once if you have chest pain, slow heart rate, blood in your stools, coughing up blood, decreased urination, weakness, confusion, extreme thirst, or hot, dry skin.

Slideshow: Flashback: FDA Drug Approvals 2013

There are many other drugs that can interact with galantamine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

If you need surgery, tell the surgeon ahead of time that you are using galantamine. You may need to stop using the medicine for a short time.

If you have stopped taking galantamine for any reason, talk with your doctor before you start taking it again. You may need to restart the medication at a lower dose.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What should I discuss with my healthcare provider before taking galantamine?

You should not use galantamine if you are allergic to it.

To make sure you can safely take galantamine, tell your doctor if you have any of these other conditions:

  • urination problems;

  • heart disease or a heart rhythm disorder;

  • a history of stomach ulcer or bleeding;

  • seizures or epilepsy;

  • kidney disease;

  • liver disease; or

  • a history of asthma or chronic obstructive pulmonary disease (COPD).

FDA pregnancy category B. Galantamine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether galantamine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take galantamine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

The galantamine extended-release capsule is usually taken once per day in the morning. Follow your doctor's instructions.

The galantamine short-acting tablet or the oral solution (liquid) are usually given two times per day, with meals. Follow your doctor's instructions.

The extended-release capsule works best if you take it with food.

Do not crush, chew, break, or open an extended-release capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

Measure the liquid using only the special dose-measuring device provided. Empty the medicine into 3 to 4 ounces of any non-alcoholic beverage. Stir this mixture and drink all of it right away. Rinse the dose-measuring device with water after each use.

The liquid form of this medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Take galantamine with a full glass of water. Drink 6 to 8 full glasses of water each day to keep from getting dehydrated while taking this medication.

If you need surgery, tell the surgeon ahead of time that you are using galantamine. You may need to stop using the medicine for a short time.

If you have stopped taking galantamine for any reason, talk with your doctor before you start taking it again. You may need to restart the medication at a lower dose.

Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe nausea, vomiting, stomach cramps, muscle weakness or spasm, watery eyes, drooling, increased urination or bowel movements, sweating, slow heart rate, feeling light-headed or fainting, and seizure (convulsions).

What should I avoid while taking galantamine?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Galantamine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using galantamine and call your doctor at once if you have a serious side effect such as:

  • chest pain, slow heart rate;

  • feeling like you might pass out;

  • blood in your urine or stool;

  • coughing up blood or vomit that looks like coffee grounds;

  • painful or difficult urination;

  • urinating less than usual or not at all;

  • weakness, confusion, decreased sweating, extreme thirst, hot dry skin; or

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • feeling tired, dizzy, or drowsy;

  • headache, blurred vision, runny nose;

  • depression, sleep problems (insomnia);

  • nausea, vomiting, stomach pain, loss of appetite;

  • weight loss; or

  • unusual or unpleasant taste in your mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Galantamine dosing information

Usual Adult Dose for Alzheimer's Disease:

Immediate release tablet and oral solution:
Initial dose: 4 mg orally twice a day, preferably with morning and evening meals.
Maintenance dose: 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.
Maximum dose: 16 to 24 mg/day

Extended release capsule:
Initial dose: 8 mg orally daily, preferably with the morning meal.
Maintenance dose: 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.
Maximum dose: 16 to 24 mg/day

Comment:
-Dose increases should be based upon assessment of clinical benefit and tolerability of the previous dose.
-If therapy has been interrupted for more than 3 days, the patient should be restarted at the lowest dosage and the dosage escalated to the current dose.
-Abrupt withdrawal of galantamine was not associated with increased frequency of adverse events
-The beneficial effects of galantamine are lost when the drug is discontinued

What other drugs will affect galantamine?

Tell your doctor about all other medicines you use, especially:

  • donepezil (Aricept);

  • erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole);

  • ketoconazole (Nizoral);

  • paroxetine (Paxil);

  • rivastigmine (Exelon);

  • atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm Scop);

  • bladder or urinary medicines such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

  • bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

  • irritable bowel medicines such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro-Banthine);

  • NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others; or

  • ulcer medications such as glycopyrrolate (Robinul) or mepenzolate (Cantil).

This list is not complete and there are many other drugs that can interact with galantamine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about galantamine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.01. Revision Date: 2012-05-14, 3:56:45 PM.

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