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Drug overview for MEMANTINE HCL ER (memantine hcl):
Generic name: MEMANTINE HCL (MEM-an-teen)
Drug class: Alzheimer's Disease Agents-NMDA Receptor Antagonists
Therapeutic class: Cognitive Disorder Therapy
Memantine hydrochloride is an N-methyl-d-aspartate (NMDA) receptor antagonist.
No enhanced Uses information available for this drug.
Generic name: MEMANTINE HCL (MEM-an-teen)
Drug class: Alzheimer's Disease Agents-NMDA Receptor Antagonists
Therapeutic class: Cognitive Disorder Therapy
Memantine hydrochloride is an N-methyl-d-aspartate (NMDA) receptor antagonist.
No enhanced Uses information available for this drug.
DRUG IMAGES
MEMANTINE HCL ER 7 MG CAPSULE
The following indications for MEMANTINE HCL ER (memantine hcl) have been approved by the FDA:
Indications:
Moderate to severe Alzheimer's type dementia
Professional Synonyms:
None.
Indications:
Moderate to severe Alzheimer's type dementia
Professional Synonyms:
None.
The following dosing information is available for MEMANTINE HCL ER (memantine hcl):
Memantine is commercially available as memantine hydrochloride; dosage is expressed in terms of the hydrochloride salt.
Memantine hydrochloride is administered orally (as tablets, extended-release capsules, or oral solution) without regard to meals. Memantine hydrochloride tablets and oral solution are equivalent on a mg-per-mg basis. The oral solution should be administered using the oral dosing syringe provided by the manufacturer, referring to the accompanying patient information for instructions.
Memantine hydrochloride oral solution should not be mixed with any other liquid. The extended-release capsules should be swallowed intact and not divided, chewed, or crushed; alternatively, the capsules may be opened, sprinkled on applesauce, and swallowed without chewing. The fixed-combination preparation containing memantine hydrochloride and donepezil hydrochloride (Namzaric(R)) may be used in patients currently receiving a stable dosage of donepezil hydrochloride 10 mg daily.
The fixed-combination capsules should be swallowed intact (and not divided, chewed, or crushed); alternatively, the capsules may be opened, sprinkled on applesauce, and swallowed without chewing. The entire contents of each capsule should be consumed; the dose should not be divided. If a dose of memantine is missed, the next dose should be taken as scheduled; the dose should not be doubled to make up for a missed dose. If treatment is interrupted for several days, the drug may need to be restarted with a lower dosage and retitrated.
Memantine hydrochloride oral solution should not be mixed with any other liquid. The extended-release capsules should be swallowed intact and not divided, chewed, or crushed; alternatively, the capsules may be opened, sprinkled on applesauce, and swallowed without chewing. The fixed-combination preparation containing memantine hydrochloride and donepezil hydrochloride (Namzaric(R)) may be used in patients currently receiving a stable dosage of donepezil hydrochloride 10 mg daily.
The fixed-combination capsules should be swallowed intact (and not divided, chewed, or crushed); alternatively, the capsules may be opened, sprinkled on applesauce, and swallowed without chewing. The entire contents of each capsule should be consumed; the dose should not be divided. If a dose of memantine is missed, the next dose should be taken as scheduled; the dose should not be doubled to make up for a missed dose. If treatment is interrupted for several days, the drug may need to be restarted with a lower dosage and retitrated.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| MEMANTINE HCL ER 7 MG CAPSULE | Maintenance | Adults take 1 capsule (7 mg) by oral route once daily for 7 days |
| MEMANTINE HCL ER 14 MG CAPSULE | Maintenance | Adults take 2 capsules (28 mg) by oral route once daily |
| MEMANTINE HCL ER 21 MG CAPSULE | Maintenance | Adults take 1 capsule (21 mg) by oral route once daily for 7 days |
| MEMANTINE HCL ER 28 MG CAPSULE | Maintenance | Adults take 1 capsule (28 mg) by oral route once daily |
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| MEMANTINE HCL ER 7 MG CAPSULE | Maintenance | Adults take 1 capsule (7 mg) by oral route once daily for 7 days |
| MEMANTINE HCL ER 14 MG CAPSULE | Maintenance | Adults take 2 capsules (28 mg) by oral route once daily |
| MEMANTINE HCL ER 28 MG CAPSULE | Maintenance | Adults take 1 capsule (28 mg) by oral route once daily |
| MEMANTINE HCL ER 21 MG CAPSULE | Maintenance | Adults take 1 capsule (21 mg) by oral route once daily for 7 days |
The following drug interaction information is available for MEMANTINE HCL ER (memantine hcl):
There are 0 contraindications.
There are 1 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Memantine/N-Methyl-D-Aspartate (NMDA) Antagonists SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: N-methyl-D-aspartate (NMDA) antagonists act at the same receptor system as does memantine.(1,2) CLINICAL EFFECTS: Concurrent use may result in more frequent and more pronounced side effects, especially CNS-related effects.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The UK manufacturer of memantine states that the concurrent use of memantine with N-methyl-D-aspartate (NMDA) antagonists such as amantadine or ketamine should be avoided.(1) The US manufacturer of memantine states that concurrent use should be approached with caution.(2) DISCUSSION: Because N-methyl-D-aspartate (NMDA) antagonists act at the same receptor system as does memantine, concurrent use may result in more frequent and more pronounced side effects, especially CNS-related effects. Therefore, the UK manufacturer of memantine states that the concurrent use of memantine with NMDA antagonists such as amantadine or ketamine should be avoided.(1) The US manufacturer of memantine states that concurrent use should be approached with caution.(2) In a study in 52 healthy subjects, concurrent memantine (20 mg daily) and dextromethorphan/quinidine (30/30 mg daily) resulted in no changes in dextromethorphan or memantine levels. There was a slight increase in dizziness as measured by the dizziness visual analog scale (VAS) when compared to memantine alone but not the combination of dextromethorphan/quinidine alone. For other pharmacodynamic assessments, there was either no effect or improvement on some subscales.(3) |
AMANTADINE, AMANTADINE HCL, BUPIVACAINE-KETOROLAC-KETAMINE, GOCOVRI, KETALAR, KETAMINE HCL, KETAMINE HCL-0.9% NACL, KETAMINE HCL-NACL, KETAMINE HCL-WATER, KETAMINE HYDROCHLORIDE, MKO (MIDAZOLAM-KETAMINE-ONDAN), OSMOLEX ER, ROPIVACAINE-KETOROLAC-KETAMINE, SPRAVATO |
There are 1 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Memantine; Amantadine/Urinary Alkalinizers SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Memantine and amantadine elimination is impaired by urinary alkalinization.(1,2) CLINICAL EFFECTS: Potentiation of memantine or amantadine effects may be observed. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Monitor patient for adverse reactions such as dizziness, headache, or confusion if a urinary alkalinizer is required. The memantine or amantadine dose may need to be adjusted when a urinary alkalinizer is started or stopped.(1,2) DISCUSSION: The clearance of memantine was reduced by about 80% under alkaline urine conditions at pH 8. Urine alkalinization may lead to an accumulation of memantine with a possible increase in adverse effects. Urine pH is also altered by diet and clinical state of the patient (e.g., renal tubular acidosis or severe infections of the urinary tract). Hence, memantine should be used with caution under these conditions.(1) A study in rats showed that concomitant administration of sodium bicarbonate with amantadine caused a decrease in amantadine renal clearance (1.16 vs. 0.76). Amantadine's area-under-the-curve (AUC) was increased approximately 78%.(3) A study in 12 healthy subjects showed that plasma concentrations of memantine are dependent on urine pH. Alkaline urine pH caused a 79% reduction in renal clearance.(4) |
ACETAZOLAMIDE, ACETAZOLAMIDE ER, ACETAZOLAMIDE SODIUM, DICHLORPHENAMIDE, K-PHOS NO.2, K-PHOS ORIGINAL, KEVEYIS, METHAZOLAMIDE, ORACIT, ORAL CITRATE, ORMALVI, POTASSIUM CITRATE ER, SODIUM ACETATE, SODIUM BICARBONATE, SODIUM BICARBONATE-D5W, SODIUM BICARBONATE-WATER, THAM, TROMETHAMINE, TROMETHAMINE-STERILE WATER, UROCIT-K, UROQID-ACID NO.2, VAXCHORA BUFFER COMPONENT |
The following contraindication information is available for MEMANTINE HCL ER (memantine hcl):
Drug contraindication overview.
Known hypersensitivity to memantine hydrochloride or any ingredient in the formulation.
Known hypersensitivity to memantine hydrochloride or any ingredient in the formulation.
There are 1 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Congenital long QT syndrome |
There are 2 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min |
| Chronic kidney disease stage 5 (failure) GFr<15 ml/min |
There are 2 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Disease of liver |
| Kidney disease with likely reduction in glomerular filtration rate (GFr) |
The following adverse reaction information is available for MEMANTINE HCL ER (memantine hcl):
Adverse reaction overview.
Common adverse effects reported with conventional preparations of memantine include dizziness, confusion, headache, and constipation. Common adverse effects reported with the extended-release capsule formulation of the drug include headache, diarrhea, and dizziness.
Common adverse effects reported with conventional preparations of memantine include dizziness, confusion, headache, and constipation. Common adverse effects reported with the extended-release capsule formulation of the drug include headache, diarrhea, and dizziness.
There are 13 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. |
Hypertension Influenza |
| Rare/Very Rare |
|---|
|
Acute renal failure Agranulocytosis Chronic heart failure Hepatitis Leukopenia Pancreatitis Pancytopenia Stevens-johnson syndrome Suicidal ideation Thrombocytopenic disorder Thrombotic thrombocytopenic purpura |
There are 16 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Constipation Cough Diarrhea Dizziness Headache disorder |
Acute abdominal pain Aggressive behavior Back pain Depression Drowsy Hypotension Symptoms of anxiety Urinary incontinence Vomiting Weight gain |
| Rare/Very Rare |
|---|
|
Pharyngitis |
The following precautions are available for MEMANTINE HCL ER (memantine hcl):
Safety and efficacy of memantine have not been established in pediatric patients. Memantine has been evaluated in children 6-12 years of age with autism spectrum disorders (ASD)+; however, efficacy has not been demonstrated. (See Uses: Autism Spectrum Disorders.)
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
There are no adequate data to inform the developmental risks associated with the use of memantine in pregnant women. In animal reproduction studies, adverse developmental effects (e.g., decreased body weight, decreased skeletal ossification) were observed when the drug was administered to pregnant rats during the period of organogenesis or from late gestation throughout lactation to weaning at doses higher than those used clinically.
It is not known whether memantine is distributed into human milk or if the drug has any effects on the nursing infant or milk production. The known benefits of breast-feeding should be considered along with the mother's clinical need for memantine and any potential adverse effects on the breast-fed infant from the drug or underlying maternal condition.
Clinical studies have been conducted principally in older patients since dementia of the Alzheimer's type occurs mainly in patients 65 years of age or older. Memantine pharmacokinetics were similar in elderly patients and younger adults.
The following prioritized warning is available for MEMANTINE HCL ER (memantine hcl):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for MEMANTINE HCL ER (memantine hcl)'s list of indications:
| Moderate to severe alzheimer's type dementia | |
| G30 | Alzheimer's disease |
| G30.0 | Alzheimer's disease with early onset |
| G30.1 | Alzheimer's disease with late onset |
| G30.8 | Other alzheimer's disease |
| G30.9 | Alzheimer's disease, unspecified |
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