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Galantamine

Brands and Forms

  • Razadyne
    • tablet: 4mg, 8mg, 12mg.
    • liquid: 4mg/ml
  • Razadyne ER
    • extended-release capsule: 8mg, 16mg, 24mg

Uses of Galantamine

Galantamine is used for treating Dementia. It delays the progression of the cognitive decline, and can also help to control some of the behavioral symptoms associated with Dementia.

How Galantamine Works

Galantamine is a cholinesterase inhibitor. It blocks the actions of centrally-acting acetylcholinesterase (AChE), thus making acetylcholine more available in the central nervous system.

Cautions when Using Galantamine

Use with caution in people with asthma and other respiratory diseases, and seizure disorder.

Dosing of Galantamine

The usual therapeutic range of Galantamine is 16-24mg/day. The immediate-release tablet or liquid is given twice a day, whereas the extended-release capsule is given once daily in the morning.

Initial dose is 16mg/day. After 4 weeks the dose may be increased to 24mg/day. Dose should not exceed 32mg/day.

When wanting to stop Galantamine, a dose taper is not required, and the medication can be stopped immediately. Discontinuation may lead to a deterioration in memory and behavior.

Onset of action

May take up to 6 weeks before any improvement in memory of behavior becomes evident.

Kidney impairment

Should be used with caution, and avoided in cases of severe renal failure.

Liver impairment

Should be used with caution, and avoided in cases of severe liver impairment.

Side-effects of Galantamine

Below is a list of most of the reported side-effects of Galantamine. Most of these side-effects occur in only a minority of individuals, and many also resolve with time while the medication is continued.

Cardiovascular: chest pain; hypertension; bradycardia; fainting; AV-block (rare).

Central Nervous System: dizziness; somnolence; headache; fatigue; insomnia; tremor; seizures (rare).

Dermatologic: purpura.

Gastrointestinal: nausea; vomiting; diarrhea; appetite loss; weight loss; abdominal pain; dyspepsia; worsening of gastric ulcers, constipation; flatulence.

Genitourinary: urinary tract infection; hematuria; urinary incontinence.

Hematologic: anemia.

Muskuloskeletal: muscle pains and weakness.

Psychiatric: anxiety; depressed mood; agitation; hallucinations.

Respiratory: rhinitis; bronchitis; coughing; upper respiratory tract infection; respiratory depression (rare).

Common side-effects of Galantamine

Nausea, vomiting, diarrhea, appetite loss, dizziness, somnolence, headache, weight loss.

Rare but serious side-effects of note of Galantamine

  • Bradycardia and AV-block
  • Seizures

Galantamine overdose

Cholinergic crisis (bradycardia, collapse, convulsions, GI cramping, hypotension, lacrimation, muscle weakness, respiratory depression, salivation, severe nausea, sweating, urination, vomiting). Can be fatal.

Galantamine and pregnancy

Category B: some animal studies have not shown adverse effects at very high doses, but no controlled human studies have been done. It is unlikely that Galantamine would be used for women of childbearing age.

Medical Monitoring for Galantamine

None for healthy individuals

Drug Interactions with Galantamine

  • Galantamine blood levels may be increased by Amitriptyline, Erythromycin, Fluoxetine, Fluvoxamine, Ketoconazole, Paroxetine, and Quinidine.
  • Bradycardia could occur if combined with beta-blockers.
  • Galantamine can work synergistically with Bethanechol and Succinylcholine