Applies to the following strength(s): 10 mg ; 5 mg ; immediate release ; 2 mg/mL ; extended release ; 7 mg ; 14 mg ; 21 mg ; 28 mg
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Alzheimer's Disease
Initial dose: 5 mg orally once a day, then titrated upwards by 5 mg per week
Maintenance dose: 5 mg once a day up to 10 mg twice a day
Maximum dose: 20 mg per day
Initial dose: 7 mg orally once a day, then titrated upwards by 7 mg per week
Maintenance dose: 7 mg once a day up to 28 mg once a day
Maximum dose: 28 mg orally once a day
Approved indication: For use in the treatment of moderate to severe dementia of the Alzheimer's type.
Renal Dose Adjustments
Mild to moderate renal impairment: No adjustment recommended
Severe renal impairment (CrCl of 5 to 29 mL/min): A target dose of 5 mg orally twice a day (IMMEDIATE-RELEASE) or 14 mg orally once a day (EXTENDED-RELEASE) is recommended.
There is insufficient data in the medical literature to recommend a safe dose in patients with a CrCl less than 5 mL/min.
Liver Dose Adjustments
Mild to moderate hepatic impairment: No adjustment recommended
Severe hepatic impairment: Caution is recommended
IMMEDIATE-RELEASE: Dosage should be increased at weekly intervals by 5 mg increments and administered in 2 divided doses daily.
EXTENDED-RELEASE: Dosage should be increased at weekly intervals by 7 mg increments and administered once daily.
Switching from IMMEDIATE-RELEASE to EXTENDED-RELEASE:
-A patient taking 10 mg 2 times a day (immediate-release) may be switched to 28 mg once a day (extended-release) the day following the last dose of 10 mg.
-Severe renal impairment: A patient taking 5 mg twice a day (immediate-release) may be switched to 14 mg once a day (extended-release) the day following the last dose of 5 mg.
Data not available
Changes in urine pH towards alkalinization (pH 8) may decrease the urinary elimination of memantine resulting in the accumulation of memantine and possible adverse effects.
Dosage escalation should occur not more frequently than once a week.
Memantine should be used with caution in patients with a history of neurological conditions since it has not been evaluated in patients with a seizure disorder.
Memantine should be administered with caution to patients with severe hepatic impairment.
For memantine oral drops solution 10 mg/mL, 10 drops of solution is equal to 5 mg of memantine.
Memantine should be taken at the same time every day and it may be administered with or without food.
The tablet and drop formulations of memantine are considered bioequivalent.
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