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Memantine/Donepezil

    Brands

    DEA Class;  Rx

    Common Brand Names; Namzaric

    • Acetylcholinesterase Inhibitors, Central; 
    • NMDA Antagonists

    Combination acetylcholinesterase inhibitor and NMDA receptor antagonist
    Used for moderate to severe Alzheimer’s disease stabilized on donepezil and/or memantine separately; adults with mixed vascular dementia and Alzheimer’s disease may experience a small cognitive benefit
    Donepezil has a known risk of QT prolongation; certain conditions, drugs, or foods that raise urine pH may decrease urinary elimination of memantine

    Indicated for the treatment of moderate to severe Alzheimer’s disease.

    Hypersensitivity to memantine, donepezil, or piperidine derivatives

    >10% (donepezil)

    • Nausea (5-19%)
    • Diarrhea (8-15%)
    • Insomnia (5-14%)
    • Accident (7-13%)
    • Infection (11%)

    1-10% (memantine)

    • Dizziness (7%)
    • Confusion (6%)
    • Headache (6%)
    • Constipation (5%)
    • Cough (4%)
    • Hypertension (4%)
    • Backache (3%)
    • Pain (3%)
    • Somnolence (3%)
    • Syncope (3%)
    • Vomiting (3%)
    • Dyspnea (2%)
    • Fatigue (2%)

    Memantine

    • Conditions that raise urine pH may decrease urinary elimination and increase plasma levels of memantine
    • Use caution in cardiovascular disease, seizure disorder, ophthalmic disease, hepatic and/or renal impairment

    Donepezil

    • Risk of GI bleed: Patients receiving therapy should be monitored closely for symptoms of active or occult gastrointestinal bleeding, especially those at increased risk for developing ulcers, eg, those with a history of ulcer disease or those receiving concurrent nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Cholinesterase inhibitors are likely to exaggerate succinylcholine-type muscle relaxation during anesthesia
    • Syncopal episodes reported in association with use of donepezil

    Pregnancy Category: B (memantine); C (donepezil)

    Lactation: Unknown if distributed in human breast milk

    Adults

    28 mg/day PO memantine extended-release with 10 mg/day PO donepezil.

    Geriatric

    28 mg/day PO memantine extended-release with 10 mg/day PO donepezil.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Infants

    Not indicated.

    Neonates

    Not indicated.

    memantine/donepezil

    capsule ER

    • 7mg/10mg
    • 14mg/10mg
    • 21mg/10mg
    • 28mg/10mg