Galantamine (Oral)

Galantamine is an oral medication that doctors prescribe to increase a chemical in the brain known as acetylcholine, which minimizes the dementia symptoms in Alzheimer's patients.

Overview

What is Galantamine?

Galantamine is a prescribed drug that is also traded under the names of Razadyne, Razadyne ER and Razadyne IR. Galantamine is available in an oral solution, an extended release capsule or a tablet form.

Patients suffering from early onset Alzheimer's disease will benefit from Galantamine therapy as it is proven to elevate acetylcholine levels in the brain, slowing down the impairment to cognitive function that many patients experience. Galantamine is not a cure for Alzheimer's and may not work for long term therapy.

How does Galantamine work?

Galantamine works by stopping the brain from consuming a chemical called acetylcholine or ACh by limiting the production of acetylcholinesterase. Acetylcholinesterase is an enzyme that breaks down acetylcholine, which is responsible for many functions in the brain and is one of the first brain chemicals to diminish when a patient experiences the decline from Alzheimer's.

Galantamine has been used for hundreds of years to affect the memory function of the brain. It is a natural substance found in plant life such as various species of the snowdrop plant, the daffodil and certain species of lily. Galantamine is now primarily created in a laboratory for use in humans.

What is ACh?

ACh or acetylcholine is a neurotransmitter responsible for many brain functions including memory, movement and bodily functions such as sweating as well as biological functions such as fat consumption. It is one of the first chemicals to diminish when a patient experiences the onset of Alzheimer's disease.

By inhibiting the body from consuming ACh, elevating the level to a more normal status, some of the symptoms of Alzheimer's disease can be diminished with the use of Galantamine.

What is Alzheimer's disease?

Alzheimer's is a neurodegenerative disease that gradually worsens over time. One of the earliest signs is the inability to remember things that have happened recently, also known as short term loss of memory. As the chronic condition progresses, it can lead to patients becoming lost in familiar surroundings, mood alterations, deterioration of hygiene and communication problems. Patients often withdraw from loved ones and the outside world. Eventually the patient experiences physical symptoms as their body functions deteriorate and they eventually die of the disease.

Not to be confused with normal age-related memory issues, Alzheimer's can only be detected with extensive testing and medical history evaluation. It is a complicated disease that has no known cure, including Galantamine.

Conditions Treated

  • Mild dementia
  • Muscular dystrophy
  • Alzheimer's type dementia
  • Dementias
  • Myasthenia
  • Diffuse Lewy body disease
  • Myopathy

Type Of Medicine

  • Cholinesterase inhibitor, reversible

Side Effects

Galantamine works directly on a chemical that is vital to the function of the entire body. In doing so, it may have adverse effects on health that are possibly severe and require attention from professional medical care staff. If you experience the following side effects, get in touch with your doctor right away:

  • Fainting, dizzy, lightheaded feelings
  • Discomfort or pain in chest area
  • Shaking hands, arms, feet or legs
  • Gasping for breath
  • Irregular or sluggish heart rhythm
  • Fatigue
  • Vision changes
  • Confused demeanor
  • Less urine or less frequent urination
  • Dizzy or lightheaded when rising
  • Dry mouth
  • Passing out
  • Pounding, fast, irregular heart rhythm
  • Warm feeling
  • Shallow, fast breathing
  • Flushed neck, face, upper chest or neck
  • Eyes appear sunken
  • Sweats
  • Thirsty
  • Difficulty breathing
  • Muscle weakness
  • Skin appears wrinkled
  • Skin symptoms such as blisters, loose or peeling areas
  • Chills
  • Coughing
  • Urine is dark in color
  • Elevated temperature
  • General weak, tired feeling
  • Headache
  • Hoarse voice
  • Irritated mood
  • Stiff, painful, swollen joints
  • Stools are light in color
  • Vomiting
  • Nausea
  • Nervous demeanor
  • Ears pound
  • Skin itches or shows rashes and hives
  • Purple centered red skin spots
  • Eyes are bloodshot and irritated
  • Skin is flushed or red
  • Swollen lips, face, eyes, feet or hands
  • Chest feels tight
  • Swallowing is difficult
  • Pain in abdomen or stomach
  • Eyes or skin appear yellow

Due to the high rate of memory issues in patients taking Galantamine, it is wise to be aware of the symptoms of overdose in case of double dosing. Both patient and care-giver should be aware of these symptoms and seek immediate emergency medical help as soon as possible:

  • Convulsions
  • Confused demeanor
  • Breathing is slow, shallow or rapid and irregular
  • Weak muscles
  • Lips, skin or fingers turn blue
  • Cramps in stomach
  • Nausea that is severe
  • Sweating
  • Eyes water
  • Muscles moving on their own and visible under skin
  • Vomiting

Other adverse health effects may occur when patients are new to Galantamine and typically disappear with time and adjustment. Your physician may be able to advise you on preventive measures that can be taken to ease these symptoms, so communicate the following if you are experiencing them:

  • Weight loss
  • Little to no appetite
  • Acid reflux
  • Gas
  • Discouraged mood
  • Sadness
  • Depression
  • General unwell, uncomfortable feeling
  • Heartburn
  • Sweating has increased
  • Indigestion or upset stomach
  • Irritable mood
  • Strength has diminished
  • Interest in pleasurable things has faded
  • Spasms in muscles
  • Difficulty concentrating
  • Insomnia
  • Dull, tired mood
  • Weak, sluggish demeanor
  • Needles and pins sensations or itching, numb, tingling in extremities or limbs
  • Taste sensation has changed or diminished
  • Dry heaves
  • Sleeping heavily or deeply
  • Sleeping for extended periods
  • Aural noises such as buzzing or ringing
  • Loss of hearing
  • Imagined sights, noises or feelings

Other adverse effects may be experienced by some patients. If your health changes after being treated with Galantamine, communicate these changes to your physician.

Dosage

Depending on your overall health and the progression of your condition, your dosage of Galantamine may differ from the general information provided below. Follow your doctor's prescription exactly and do not increase your dosage unless instructed specifically by your health care provider. Do not change the frequency or time of day that you take your dose or doses and do not lengthen the treatment period.

Oral tablets or solution

Alzheimer's patients will typically be instructed to take 4 milligrams twice daily, increasing to 8 milligrams for each of two daily doses after a 4 week period, followed by 12 milligrams twice daily after another 4 weeks. Children will have their dosage determined by their physician based on several body and health factors.

Extended release capsule

Adult Alzheimer's patients are normally instructed to take one 8 milligram capsule with food once per day. This dosage will increase to 16 milligrams daily after 4 weeks followed by 24 milligrams another 4 weeks after that. Use of Galantamine in pediatric patients will be specifically addressed on a case by case basis.

Missing a dose of Galantamine should not cause you to double dose as this will risk overdose symptoms and your overall good health. If you are far enough away from your next dosage, take the missed dose as soon as you remember. If you are close to your next dosage time by the time you realize you've missed a dose, skip it in favor of resuming your regular schedule as soon as possible.

Patients taking capsules that have an extended release mechanism should take them with their breakfast in the morning, taking the capsule whole without breaking, crushing or chewing.

Oral liquid should be taken with the measuring cup, syringe or spoon that was provided with the prescription. Do not use household utensils to measure a dosage, as these items vary greatly.

Your doctor will most likely instruct you to hydrate yourself more with use of this medication, which assists the body in flushing the kidneys by passing more urine, thus avoiding any complications with this medication remaining in your system too long.

Interactions

Inform your physician if you have ever experienced sensitivity to any other prescription drugs. You will also need to remember to disclose any sensitive reactions you've had to foods, animals, preservatives, dyes or perfumes prior to being treated with Galantamine.

Pediatric patients have not been studied for use of Galantamine that would demonstrate that it is safe or effective for this age group. Use of this drug on pediatric patients is at the discretion of the physician.

Geriatric patients have not been studied with regard to any limited effectiveness or increased risk factors as compared to adult patients.

Women who are pregnant and women who are breastfeeding have not been adequately studied for use of Galantamine with regard to how it affects their unborn or breastfeeding children. Use of Galantamine on these groups is not recommended for safety reasons.

Some drugs work in conjunction to provide an overall health regimen for individuals with numerous symptoms. Other medications should never be taken together for any reasons. While you are taking a prescription of Galantamine, it is important to tell your doctor about any other medications you are taking and to include herbal, over the counter, holistic and even vitamin supplements to avoid any adverse reactions.

The following medications should not be prescribed with Galantamine for any reason. If you are taking any of these, your doctor may want to change your prescriptions or dosage amounts:

  • Amifampridine
  • Bepridil
  • Amisulpride
  • Dronedarone
  • Cisapride
  • Pimozide
  • Mesoridazine
  • Saquinavir
  • Piperaquine
  • Terfenadine
  • Sparfloxacin
  • Ziprasidone
  • Thioridazine

While not usually recommended, the use of Galantamine and one or more of the following medications may be necessary for your treatment. In case of required dosage adjustment, make sure your physician is aware that you are taking:

  • Anagrelide
  • Amiodarone
  • Arsenic Trioxide
  • Aripiprazole
  • Buserelin
  • Bupropion
  • Crizotinib
  • Clarithromycin
  • Degarelix
  • Dabrafenib
  • Deslorelin
  • Delamanid
  • Donepezil
  • Domperidone
  • Escitalopram
  • Efavirenz
  • Gonadorelin
  • Fluoxetine
  • Histrelin
  • Goserelin
  • Hydroxyzine
  • Hydroxychloroquine
  • Leuprolide
  • Ivabradine
  • Metronidazole
  • Levofloxacin
  • Nafarelin
  • Moxifloxacin
  • Panobinostat
  • Ondansetron
  • Pazopanib
  • Pasireotide
  • Pitolisant
  • Pimavanserin
  • Sevoflurane
  • Quetiapine
  • Sulpiride
  • Sotalol
  • Triptorelin
  • Tacrolimus
  • Vemurafenib
  • Vandetanib
  • Zuclopenthixol
  • Vinflunine

The following medications, if taken with Galantamine prescription treatment, may increase the possibility that you will experience certain adverse health effects. Inform your physician if you are taking any of the following medications:

  • Amitriptyline
  • Ketoconazole
  • Fluvoxamine
  • Paroxetine
  • Oxybutynin
  • Tolterodine
  • Quinidine

Discuss the consumption of alcoholic beverages or certain foods while you are being treated with Galantamine. The use of tobacco products should also be a topic of conversation with your physician in case any risks associated with these products are greater because of taking this medication.

The following diseases and health conditions may interfere with the way Galantamine affects your brain chemical levels or may even become worse with use of this drug. Inform your doctor or make sure your medical history documentation includes them if you suffer from any of the following:

  • Bowel surgery, stomach blockage or any surgical procedures on the stomach or abdomen
  • Kidney disease
  • Liver disease
  • Cardiac rhythm problems
  • Blockage to urinary tract or bladder
  • Ulcers, bleeding in the stomach
  • Seizures
  • Lung diseases
  • Asthma

Warnings

Your physician will require you to keep regular office visits to determine if Galantamine is working on your symptoms or if it is causing adverse effects on your overall health.

You may experience severe reactions manifested in your skin while on a prescription of Galantamine. Any skin that is peeling, blistered or loose should be reported to your health care provider. Additionally, if you have rashes, acne, ulcers or sores accompanied by chills or elevated body temperature while you are taking Galantamine, inform your physician right away.

Problems in the bowel or stomach may occur with a prescription of Galantamine, so inform your physician if you show signs of diarrhea, nausea, stomach pain, vomiting, little to no appetite or loss of weight.

Overdose symptoms may include convulsions and enlarged pupils, breathing that is irregular and a rapid heart rhythm. Being severely nauseated accompanied by vomiting or showing a weakness in the muscles, sweating profusely or salivating and drooling are also signs of overdose. Seek emergency medical assistance right away if you or your caregiver notices these symptoms.

Other medications should be avoided when you are on a prescription dosage of Galantamine unless they are specifically assigned to you for your overall health treatment.

Patients with severe or chronic diseases of the kidneys or liver should inform their physician of these conditions prior to being prescribed Galantamine. Additionally, those with breathing or lung diseases or cardiac disorders, problems urinating or stomach and bowel diseases should also be aware that these conditions can be worsened by taking Galantamine.

All of the health care professionals that will be treating you while you are taking Galantamine should be made aware of your use of this drug. This includes any emergency medical staff as well as dentists and nurses that provide you care.

Storage

Keep your prescribed amount of Galantamine in the original packaging at room temperature, well away from light, moisture or heat exposure. Galantamine, as with all other drugs, should be kept out of sight and reach of children and pets. If you have expired Galantamine or unused doses of this medication, consult with your doctor or pharmacist on the safest way to dispose of this drug. Never share this medication with other people even if they have the same condition as you.

Summary

Galantamine is a parasympathomimetic drug that inhibits the production of an enzyme in the brain known as acetylcholinesterase. This enzyme consumes another chemical found in the brain called acetylcholine or ACh, which is important to numerous biological functions including motor skills, memory and digestion. One of the earliest chemicals to diminish in the brain in Alzheimer's sufferers is ACh. By elevating the level of this chemical, Galantamine holds off the dementia symptoms associated with this disease for a period of time. Galantamine is not a cure for dementia or Alzheimer's.

Taken in a gradually increasing dosage that is ramped up every four weeks, Galantamine is available in oral liquid, tablet and time release capsule forms. By taking this medication with the morning meal, patients can better remember their dosage as well as keep a continuous amount of the drug in their system, which helps Galantamine be more effective against symptoms.

Adverse effects on health may include stomach upsets including gas, bloating, nausea, or diarrhea and vomiting. Fainting spells, sluggish heart rhythm or trouble urinating are more serious effects as are showing signs of blood in stool, vomit or urine. Any symptoms such as these should be reported to your physician right away. Seek emergency assistance if you or the patient under your care shows any signs of overdose or shock while taking Galantamine.

Pediatric patients, women who are pregnant and women who are breastfeeding should not be prescribed this drug for safety reasons unless their physician has discussed the possible risks faced to these groups prior to prescribing Galantamine.

Avoid taking any other medications when you are on a prescription dose of Galantamine including those found over the counter and at the health food store. Inform your physician of all medications you are taking, any hypersensitive reactions you've experienced in the past and your health history. Patients with diseases of the heart, kidney or liver or those who have stomach or bowel conditions may not be safe in taking Galantamine. Inform all health professionals who have care of you that you are on this medication for your own safety.