Memantine ER

Class
Anti-dementia agents
Subclass
NMDA receptor antagonists
Substance name
Memantine hydrochloride ER
Brand names
Namenda XR®
Common formulations
Capsule
See also
Memantine (Namenda®)
Dosage and administration
Adults patients
Treatment of Alzheimer's disease • Moderate-to-severe
•
Start at: 7 mg PO daily
•
Maintenance: 28 mg PO daily
Titrate in 7 mg increments weekly.
Indications for use
Labeled indications
Adults
•
Treatment of Alzheimer's disease (moderate-to-severe)
Safety risks
Contraindications
Hypersensitivity to memantine or its components
Warnings and precautions
Increased serum memantine levels
•
Use caution in patients with conditions raising urinary pH and decreasing the urinary elimination of memantine, such as renal tubular acidosis or severe UTIs.
Specific populations
Renal impairment
CrCl ≥ 30 mL/min
•
Use acceptable. No dose adjustment required.
CrCl < 30 mL/min
•
Maximal dose of 7 mg. Do not exceed frequency of BID.
Renal replacement therapy
Any modality
•
Dose as in CrCl < 30 mL/min.
Hepatic impairment
Child-Pugh A (mild)
•
Use acceptable. No dose adjustment required.
Child-Pugh B (moderate)
•
Use acceptable. No dose adjustment required.
Child-Pugh C (severe)
•
Use with caution.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B2
•
Use only if benefits outweigh potential risks. Evidence of fetal harm in animals.
Breastfeeding
Use only if benefits outweigh potential risks.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Common 1-10%
•
Hypertension, hypotension, aggressive behavior, influenza virus infection, abdominal pain, anxiety, back pain, confusion, constipation, cough, depression, diarrhea, diarrhea, dizziness, dyspnea, fatigue, hallucinations, headache, somnolence, urinary incontinence, vomiting, vomiting, weight gain
Uncommon < 1%
•
Seizure
Unknown frequency
•
Acute pancreatitis, agitation, bradycardia, peripheral edema, syncope, falls, agranulocytosis, cholestasis, myocardial infarction, urinary tract infections, ↓ WBC count, ↓ platelet count, heart failure, hepatitis, pneumonia, bronchitis, pancytopenia, renal failure, loss of appetite, nausea, arthralgia, anemia, gait disturbance, insomnia, skin rash, Stevens-Johnson syndrome, thrombotic thrombocytopenic purpura, toxic epidermal necrolysis
Interactions
Drug(s)
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