Memantine/donepezil

Memantine/donepezil is a  prescription medication used for the treatment of Alzheimer's disease.

• Memantine/donepezil is available under the following different brand names: Namzaric

Common side effects of Memantine/donepezil include:

• diarrhea,
• dizziness, and
• headache
• upper respiratory tract infection.

Serious side effects of Memantine/donepezil include:

• severe headache,
• blurred vision,
• pounding in the neck or years,
• convulsions (seizure), and
• unusual changes in mood or behavior

Rare side effects of Memantine/donepezil include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Capsule ER

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

Alzheimer Disease

Adult dosage

• The recommended dose is 28 mg/10 mg orally every day
• Stabilized on donepezil and not currently on memantine
  • The starting dose is 7 mg/10 mg orally, taken once a day in the evening
  • Increase dose in 7 mg increments based on the memantine component to the recommended maintenance dose of 28 mg/10 mg once daily
  • The minimum recommended interval between dose increases is 1 week
  • Only increase if the previous dose is well tolerated
  • Maximum dose: 28 mg/10 mg every day
• Stabilized on both donepezil and memantine
  • Patients on memantine (10 mg BID or 28 mg extended-release every day) and donepezil 10 mg/day can be switched to Namzaric 28 mg/10 mg orally, taken once a day in the evening
  • Initiate the day following the last dose of memantine and donepezil administered separately

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Memantine/donepezil has severe interactions with the following drugs:
  • dronedarone
  • thioridazine
• Memantine/donepezil has serious interactions with at least 81 other drugs.
• Memantine/donepezil has moderate interactions with at least 166 other drugs.
• Memantine/donepezil has minor interactions with at least 140 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to memantine, donepezil, or piperidine derivatives

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Memantine/donepezil?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Memantine/donepezil?”

Cautions

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 were reported in association with the use of donepezil
• Cholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes manifesting as bradycardia or heart block
• May cause diarrhea, nausea, and vomiting; effects have been mild and transient, sometimes lasting one to three weeks, and have resolved during continued use of donepezil hydrochloride; observe patients closely at the initiating of therapy
• May cause anorexia and/or weight loss (dose-dependent)
• Cholinomimetics may cause bladder outflow obstructions
• Cholinomimetics are believed to have some potential to cause generalized convulsions
• Cholinesterase inhibitors should be prescribed with care with a history of asthma or obstructive pulmonary disease

Pregnancy & Lactation

• May be acceptable during pregnancy for memantine, but use with caution if the benefits outweigh the risk during pregnancy for donepezil

Lactation

• Unknown if distributed in human breast milk