Memantine (Oral)

Memantine treats severe (or moderate) symptoms of Alzheimer's disease.

Overview

Memantine is a prescription medication that treats severe (or moderate) symptoms of Alzheimer's disease. It does not completely cure the disease, however it can be highly effective for treating symptoms. This medication is helpful for improving patient awareness, completion of daily functions, and improving overall memory with this medication. Memantine is typically well-tolerated.

Glutamate is produced in the brain and is a naturally occurring substance. This medication blocks actions taken by NMDA receptors within the glutamatergic system because it is thought to be associated with Alzheimer's disease symptoms.

This medication is especially helpful for patients who are not able to take medications with AChE (acetylcholinesterase) inhibitors due to intolerance or other reasons.

Memantine can be obtained only with a valid prescription from your physician. It is available in solution, tablet, and capsule (extended-release) form. Memantine is currently manufactured under the US brand names Namenda, Namenda XR, and Namenda XR Titration Pack. This medication lacks many of the psychoactive side effects that recreational drug users seek, such as hallucinations and euphoria.

Condition treated

  • Alzheimer's disease

Type of medicine

  • Cognition-enhancing medication

Side Effects

In addition to necessary benefits, medications can also trigger undesired side effects. While it is not typical for each one of the following side effects to take place, if they do take place they could require medical care.

Consult with your physician right away if you experience any of the side effects below:

Less common side effects (medical care required):

  • Vision blurriness
  • Unusual weight loss or gain
  • Tingling of the feet or hands
  • Swelling or bloating of the feet, lower legs, hands, arms, or face
  • Quick or sudden weight gain
  • Pounding within the ears
  • Nervousness
  • Headache
  • Fast or slow heartbeat
  • Dizziness

Additional side effects (occurrence rate unknown):

  • Yellow skin and eyes
  • Worm-like or rapid tongue movements
  • White spots, ulcers, or sores on the lips or in the mouth
  • Weakness, tension, or pain when walking (subsides while resting)
  • Vomiting (severe)
  • Vomiting (continuous)
  • Vomiting
  • Urine that is dark in color
  • Urine output reduced
  • Twitching of muscles
  • Tingling or numbness in the legs, arms, or face
  • Swelling of hands, ankles, or face
  • Swelling for pain in the legs or arms (no presence of injury)
  • Sweating increase
  • Stupor
  • Stools that are light in color
  • Stools tarry or black
  • Stomach or abdominal pain
  • Slow, pounding heartbeat
  • Skin loosening, peeling, or blistering
  • Skin lesions (red, typically with purple middle)
  • Severe weakness (sudden)
  • Seizures
  • Red spots or pinpoints on skin
  • Quick weight gain
  • Pulse loss (absence of)
  • Puckering or lip smacking
  • Pale skin (unusual)
  • Pain in the abdomen, side, or stomach (potentially moving towards back)
  • Muscle stiffness (severe)
  • Movements of legs, arms, face, lips, or tongue (uncontrolled, twisting, or twitching)
  • Low or high blood pressure
  • Lethargy
  • Itching
  • Irregular, pounding, or fast pulse or heartbeat
  • Infection due to breathing in foreign substances
  • Indigestion
  • Hostility
  • High fever
  • Headache (severe)
  • Gums bleeding
  • General sensation of weakness or tiredness
  • Fainting (recurrent)
  • Fainting
  • Eye irritation (red)
  • Difficulty walking or speaking
  • Depression
  • Convulsions
  • Constipation (severe)
  • Constipation
  • Consciousness loss
  • Coma
  • Chewing motions uncontrolled
  • Chest pain
  • Cheeks puffiness
  • Bruising or bleeding (unusual)
  • Breathing difficulty
  • Body jerking (entire body)
  • Blood pressure loss (absence of)
  • Blood in the stools or urine
  • Agitation

Certain side effects could transpire that may not usually require medical care. These particular side effects could lessen while you are taking this medication as your body becomes more attuned to the drug. In addition, your doctor can likely let you know you other approaches to prevent certain side effects, or reduce their occurrence. Consult with your physician if you have questions regarding the side effects below, or if they become prolonged or troublesome.

More common side effects (medical care not required):

  • Confusion

Less common side effects (medical care not required):

  • Wheezing
  • Weakness or tiredness (unusual)
  • Vomiting
  • Urination urges frequent
  • Unusual drowsiness or sleepiness
  • Unsteadiness or clumsiness
  • Tiredness
  • Throat soreness
  • Sleeping difficulty
  • Restlessness
  • Pleasure or interest loss
  • Painful, burning, or difficulty urinating
  • Pain
  • Nervousness
  • Nausea
  • Muscle stiffness or pain
  • Moving difficulty
  • Joint pain
  • Joint pain
  • Irritability
  • Insomnia
  • Hyperventilation
  • General sensation of illness or discomfort
  • Fever
  • Feelings of emptiness or sadness
  • Feeling, hearing, or seeing things not actually there
  • Fear
  • Dry mouth
  • Discouragement
  • Diarrhea
  • Coughing
  • Cough that produces mucus
  • Concentration difficulty
  • Cloudy or bloody urine
  • Chills
  • Chest tightness
  • Change in balance and walking
  • Breathing difficulty
  • Breath shortness
  • Bladder pain
  • Bladder control loss
  • Back pain
  • Appetite loss
  • Anxiety

Additional side effects (occurrence rate unknown, medical care not required):

  • Upset stomach
  • Tingling, pain, numbness, or burning in all fingers besides pinkie finger
  • Swallowing difficulty
  • Stomach cramps
  • Stomach area tenderness
  • Speech slurriness
  • Shakiness
  • Reduced interest in sexual intercourse
  • Pale, cool skin
  • Nightmares
  • Loss in sexual performance, drive, desire, or ability
  • Large quantities of fat within blood
  • Inability to keep or have an erection
  • Hunger increase
  • Heartburn
  • General sensation of illness or discomfort
  • Cold sweats
  • Burning sensation within stomach or chest
  • Bloody or watery diarrhea

Additional side effects not included here can also take place for certain patients. If other side effects are observed, consult with your medical professional.

Contact your physician if you are seeking medical help regarding side effects of memantine. The Food and Drug Administration also acknowledges reports of side effects patients may experience. These reports can be submitted to the FDA by dialing 1-800-FDA-1088.

Dosage

Memantine must be taken precisely as prescribed by your physician. Never take an amount of memantine that is greater than prescribed by your doctor. Do not take memantine for a duration that is longer than your doctor intended. Memantine is distributed with an informational pamphlet for the patient. Be sure to follow and read the directions carefully. Consult with your physician with any questions you may have.

Memantine may be taken with food or without.

The extended-release tablets must be taken in one piece. Never chew, crush, or break them. If the patient cannot swallow the pill whole, the tablet may be emptied into a type of small food similar to applesauce. Mix the combination completely and swallow without chewing.

Notes regarding oral liquid form of memantine:

  • Take the oral dosage syringe off the container along with the plastic tube and cap, attach the cap to the tube.
  • Remove the cap (child-resistant) from the bottle by pushing on the top of the cap at the same time as turning it to the left (counter-clockwise) and take the seal and cap off of the bottle.
  • Put the plastic tube into into the bottle completely and tighten the cap to the bottle by tightening the cap to the right (clockwise).
  • Make sure the bottle stays upright on the tabletop, and take the lid off to expose the open area on the top portion of the lid. Keep the plunger depressed, and firmly put the top of the syringe into the cap opening.
  • Hold the syringe and pull the plunger up to bring medication into the body of the syringe.
  • Take the syringe out of the opening in the cap. Put the syringe upside down, and make sure the tip is pointing up. While the syringe is vertical, carefully push out any air bubbles if they are in the medication. Keep holding the plunger upwards.
  • Place the syringe tip into the opening of the cap again. Hold the syringe and gently pull the plunger until the tip of the black ring touches the measurement corresponding with the prescribed dose.
  • Take the syringe out of the bottle, and swallow the entire dose directly from the opening of the syringe. Do not mix memantine with another kind of liquid.
  • Reseal after done using and snap the lid completely closed.
  • Rinse dosing instruments by putting the syringe opening into water, pulling the syringe plunger out to suck in water, and push the dosage plunger out to empty the water. Repeat this process a few times. Give the syringe a chance to air dry.

Different patients will receive a unique dose of this medication. Follow all orders given by your doctor or the instructions on the medication label. The information summarized here will only go over typical doses of this medication. If you were prescribed a dose that differs from the information here, do not adjust your dose unless instructed to do so by your physician.

The dosage quantity you are prescribed depends on how strong the medication is. In addition, the number of doses taken per day, the allotted time between each dose, and the total duration for which you take memantine is dependent on the medical issue for which the medication is prescribed.

Typical dose to treat Alzheimer's disease:

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    • Oral dosage information (extended-release tablets):

O Adults: Initally, take 7 mg (milligrams) per day. Your physician may slowly increase the dose as required. However, the total dose is not typically greater than 28 milligrams daily.
O Children: Pediatrician must determine dose and usage recommendations.

    • Oral dosage information (tablets and solution):

O Adults: Initially, take 5 mg (milligrams) per day. Your medical care professional may increase your dosage information gradually as required. However, typical dose should not exceed 10 mg twice daily.
O Children: Pediatrician must calculate individual dosage and guidelines for use based on patient's needs.

If a patient misses a dose of memantine, it should be taken shortly after it is remembered. However, if it is nearer to the scheduled next dose, the skipped dose may remain missed and you may return to your original dosage schedule. Never take a double dose of memantine. Ask your doctor how to proceed if it has been a long period of time since the dose should have been taken.

Interactions

Some medications should not ever be taken at the same time, however in certain cases two medications may be combined despite the chance that interaction may take place. Under these circumstances, your physician may alter your prescribed dose, or they may choose to take other defenses to safeguard you as a patient. While taking memantine, it is imperative that your doctor is aware if you are already on any of the following medications. The interactions listed here were chosen according to the potential significance of the interaction. The list is not all-inclusive.

Taking memantine with any of the medications below is not typically suggested, however certain circumstances may require it. If both medications are prescribed at the same time, your physician may alter the dose or frequency for either or both medications. The unique medical condition of the patient may warrant the combination if the need outweighs the potential risk.

  • Sodium Bicarbonate
  • Methazolamide
  • Ketamine
  • Dorzolamide
  • Dextromethorphan
  • Bupropion
  • Brinzolamide
  • Amantadine
  • Acetazolamide

Some medications should not be taken near mealtime or when eating particular kinds of food due to the possibility of interactions taking place. The use of tobacco or alcohol in addition to some medications can also trigger the occurrence of interactions. Ask your doctor how the use of tobacco, alcohol, or food may impact memantine.

Patients who have other kinds of medical issues may experience usefulness in the effectiveness of memantine. Be sure to inform your physician of other medical issues you may have, specifically:

  • Seizures or epilepsy
  • Kidney disease
  • Urinary tract issues (such as difficulty urinating, bladder issues) take caution; these conditions could be made worse with memantine
  • Liver disease' take caution, effects could be heightened due to slower excretion of the medication from your body.

Warnings

It is imperative that your physician monitors your progress regularly to ensure memantine is working as it should and to monitor for undesired side effects.

Other medications should not be taken in conjunction with memantine unless your physician has previously approved them. This refers to nonprescription and prescription medications, as well as vitamin supplements and herbal remedies.

When contemplating whether or not a medication is right for you, patients should carefully compare the possible risks against the potential benefits it may provide. Patients should make this decision with their physician. For memantine, consider the following aspects prior to taking this medication.

Inform your physician if you currently have, or have had allergic or unusual reactions to memantine or other medications. Also inform your doctor of other kinds of allergies you may have, including to animals, preservatives, dyes, or foods. For products that are not prescription, be sure to read the ingredients summary or package label carefully.

Research has not yet identified any issues memantine could have for pediatric patients, as it is typically prescribed for elderly patients with Alzheimer's disease.

Current research has not identified any issues regarding memantine for elderly patients.

Pregnant patients should take caution prior to taking memantine while pregnant. Either there has not been adequate research conducted for pregnant women or animal research has proven a negative effect; or animal research has identified a negative effect, but similar research in pregnant ladies has demonstrated no risk to the baby.

Adequate research for pregnant women has not identified any risk to the baby if the mother takes memantine while breastfeeding. Women who are considering breastfeeding while taking memantine should compare the possible benefits against the risks prior to taking memantine during breastfeeding.

Storage

Memantine must be kept in a sealed container at room temperature, away from direct light, moisture, heat, and freezing temperatures. Keep this medication out of children's reach at all times. Never keep medication that is not required any longer or that is outdated. Consult with your medical care professional to find out how to correctly throw away any unused medication.

Summary

Memantine is a prescription medication that is effective for treating severe (or moderate) signs of Alzheimer's disease. It does not cure the disease completely, although it can be highly effective for treating Alzheimer's symptoms. Completion of daily tasks, and improving awareness and memory can take place with this medication. Memantine is normally well-tolerated.

Glutamate is produced in the brain and occurs naturally. Memantine blocks actions taken by NMDA receptors inside the glutamatergic system because it is believed to be associated with Alzheimer's disease symptoms.

This medication is additionally helpful for patients who are not able to take medications with AChE (acetylcholinesterase) inhibitors due to physical intolerance or other reasons.