tacrine

Generic Name: tacrine (TAK rin)
Brand Name: Cognex

What is tacrine?

Tacrine 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.

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

Tacrine may also be used for purposes other than those listed in this medication guide.

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

Before taking tacrine, tell your doctor if you have heart disease or a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats), an enlarged prostate, urination problems, asthma, obstructive pulmonary disease, or a seizure disorder such as epilepsy.

Tacrine is most effective when taken between meals on an empty stomach, but you may take it with food if it upsets your stomach.

Slideshow: Flashback: FDA Drug Approvals 2013

It is important to use tacrine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

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

Do not change your tacrine dose without your doctor's advice. Taking this medication improperly can lead to serious behavioral side effects or a worsening of Alzheimer's symptoms.

Call your doctor at once if you have serious side effects such as confusion, hallucinations, extreme or sudden changes in behavior, seizure (convulsions), pain or burning when you urinate, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Do not stop taking this medication without first talking to your doctor. If you stop taking tacrine suddenly, your condition may become worse.

Tacrine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

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

Do not use this medication if you are allergic to tacrine, or if you have ever had jaundice or other liver problems while taking tacrine.

Before taking tacrine, tell your doctor if you are allergic to any drugs, or if you have:

  • liver disease;

  • heart disease;

  • a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats);

  • a history of stomach ulcers;

  • an enlarged prostate or urination problems;

  • epilepsy or other seizure disorder; or

  • asthma or chronic obstructive pulmonary disease (COPD).

If you have any of these conditions, you may not be able to use tacrine, or you may need dosage adjustments or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether tacrine 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 tacrine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medication with a full glass of water.

Tacrine is most effective when taken between meals on an empty stomach, but you may take it with food if it upsets your stomach.

It is important to use tacrine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

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

Do not change your tacrine dose without your doctor's advice. Taking this medication improperly can lead to serious behavioral side effects or a worsening of Alzheimer's symptoms.

When you first start using tacrine, you may have minor side effects such as nausea, vomiting, or diarrhea. These side effects may also occur whenever your dose is changed, or if you start taking tacrine again after being off the drug for awhile.

Do not stop taking this medication without first talking to your doctor. If you stop taking tacrine suddenly, your condition may become worse.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking tacrine. You may need to stop using the medicine for a short time.

Store tacrine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include severe nausea or vomiting, drooling, sweating, slow heart rate, feeling light-headed, fainting, muscle weakness, seizure (convulsions), coma, or respiratory failure (breathing stops).

What should I avoid while taking tacrine?

Tacrine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Tacrine 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.

Call your doctor at once if you have any of these serious side effects:

  • confusion, hallucinations;

  • extreme or sudden changes in behavior;

  • seizure (convulsions);

  • pain or burning when you urinate; or

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

Less serious side effects of tacrine include:

  • mild nausea, vomiting, diarrhea, upset stomach;

  • weight loss;

  • urinating more than usual;

  • agitation, depressed mood;

  • skin rash, increased sweating;

  • fever or chills, runny nose, cough;

  • dizziness, drowsiness, tired feeling;

  • joint or muscle pain; or

  • weakness, lack of coordination.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Tacrine Dosing Information

Usual Adult Dose for Alzheimer's Disease:

Initial dose: 10 mg orally 4 times a day (between meals if possible) for 6 weeks.
Maintenance dose: May increase to 20 mg orally 4 times a day.
Further increases of 120 mg and 160 mg/day may be done in 6 week intervals.

What other drugs will affect tacrine?

Before taking tacrine, tell your doctor if you are using any of the following drugs:

  • atropine (Atreza, Sal-Tropine, and others);

  • cimetidine (Tagamet);

  • dicyclomine (Bentyl);

  • donepezil (Aricept);

  • fluvoxamine (Luvox);

  • galantamine (Razadyne);

  • glycopyrrolate (Robinul);

  • hyoscyamine (Anaspaz, Levbid, Levsin, Nulev, and others);

  • mepenzolate (Cantil);

  • methscopolamine (Pamine);

  • propantheline (Pro-Banthine);

  • rivastigmine (Exelon);

  • scopolamine (Maldemar, Scopace, Transderm-Scop); or

  • theophylline (Theo-Dur, Elixophyllin, Theolair, Slo-Bid, Uniphyl).

If you are using any of these drugs, you may not be able to use tacrine, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect tacrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has information about tacrine written for health professionals that you may read.
  • 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: 1.06. Revision Date: 2010-12-15, 5:01:39 PM.

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