Classes
DEA Class; Rx
Common Brand Names; Namzaric
- Acetylcholinesterase Inhibitors, Central;
- NMDA Antagonists
Description
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
Indications
Indicated for the treatment of moderate to severe Alzheimer’s disease.
Contraindications
Hypersensitivity to memantine, donepezil, or piperidine derivatives
Adverse Effects
>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%)
Warnings
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 and Lactation
Pregnancy Category: B (memantine); C (donepezil)
Lactation: Unknown if distributed in human breast milk
Maximum Dosage
28 mg/day PO memantine extended-release with 10 mg/day PO donepezil.
28 mg/day PO memantine extended-release with 10 mg/day PO donepezil.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
Not indicated.
Not indicated.