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Galantamine Dosage

Medically reviewed on March 10, 2017.

Applies to the following strengths: 4 mg; 8 mg; 12 mg; 4 mg/mL; 16 mg; 24 mg

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
-After a minimum of four weeks, increase to 8 mg twice a day, then after an additional 4 weeks, may increase to 12 mg twice a day
Maintenance dose: 16 to 24 mg per day given in 2 divided doses
Maximum dose: 24 mg/day

Extended release capsule:
Initial dose: 8 mg orally once a day, preferably with the morning meal
-After 4 weeks, dose should be increased to 16 mg once a day, a further increase to 24 mg once a day may be considered after a minimum of 4 weeks of taking 16 mg/day
Maintenance dose: 16 to 24 mg orally once a day based on clinical benefit and tolerability
Maximum dose: 24 mg/day

Conversion from Immediate-Release (IR) Tablets or Oral Solution to Extended-Release (ER) Capsules:
-Take the last dose of IR formulation n in the evening prior to starting ER capsule; start ER capsule following morning at once a day dosing
-Converting from IR to ER should occur at the same total daily dosage

Comments:
-During clinical trials, an immediate-release dose of 32 mg per day was found to be less well tolerated and did not increase clinical benefit; dosing at 24 mg/day was not found to provide statistically significant increased clinical benefit from 16 mg/day; however, it might provide additional benefit for some patients.
-Dose increases should be based upon assessment of clinical benefit and tolerability of the previous dose.
-If therapy is interrupted for more than 3 days, the patient should be restarted at the lowest dosage and the dosage escalated to current dose.

Use: For the treatment of mild to moderate dementia of the Alzheimer's type.

Renal Dose Adjustments

Moderate renal impairment (CrCl 9 to 59 mL/min: Maximum daily dose should generally not exceed 16 mg/day
Severe renal impairment (CrCl less than 9 mL/min): Not recommended

Liver Dose Adjustments

Moderately Impaired Hepatic Function (Child-Pugh score of 7 to 9): Maximum daily dose should generally not exceed 16 mg/day
Severe Hepatic Impairment (Child-Pugh score of 10 to 15): Not recommended

Precautions

CONTRAINDICATIONS:
-Hypersensitivity to active drug or any product excipients

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
Ensure adequate fluid intake during therapy
-Immediate-release tablets and oral solution: Take orally twice a day, preferably with morning and evening meals
-Extended-release capsules: Take orally once a day, in the morning, preferably with food

-If therapy is interrupted for more than 3 days, patient should restart at the lowest dose and escalate to their current dose.

Storage requirements: Do not freeze the oral solution

General:
-Dose increases should be based upon assessment of clinical benefit and tolerability of the previous dose.
-The abrupt withdrawal of this drug has not been associated with increased frequency of adverse events.
-The beneficial effects of the drug are lost when the drug is discontinued.

Monitoring:
-Monitor weight
-Monitor for seizure activity
-Monitor respiratory function
-Monitor for gastrointestinal bleeding
-Monitor for skin rash

Patient advice:
-Patients should be instructed to stay hydrated throughout therapy
-Patients should be instructed to stop therapy and contact their healthcare provider promptly if they develop a skin rash.
-Patients should be instructed to contact their healthcare provider if they miss more than 3 consecutive days of therapy as retitration will be needed.
-Patients taking oral solution should be provided with an instruction sheet describing how the solution is to be administered.
-Patients should be counseled on their ability to drive and/or performance of hazardous activities; this drug may cause dizziness and somnolence, especially during first weeks of therapy.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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