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Memantine

Brands and Forms

  • Namenda
    • tablet: 5mg, 10mg.
    • oral solution: 2mg/ml
  • Ebixa

Uses of Memantine

Memantine is used for slowing the memory and cognitive decline and moderating the behavioral disturbances in Dementia. It can also be helpful for chronic pain.

How Memantine Works

Memantine is a non-competitive antagonist at the NMDA receptor.

Cautions when Using Memantine

Standard considerations.

Dosing of Memantine

Memantine is started at 5mg/day, and can be increased by 5mg every week up to 20mg/day. Doses above 5mg/day should be given twice a day.

Onset of action

It can take months to notice any stabilization in memory and cognitive functioning. Behavioral disturbances may show improvement after a couple of weeks.

Kidney impairment

Recommend lowering the dose in moderative kidney impairment. Avoid using in severe kidney impairment.

Liver impairment

Dose adjustment not required.

Side-effects of Memantine

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

Cardiovascular: hypertension; fainting; heart failure (rare).

Central Nervous System: dizziness; confusion; headache; somnolence; unsteadiness; slow movements; ,virtigo; seizures (rare); stroke (rare).

Dermatologic: rash.

Endocrine/Metabolic: weight loss.

Eyes, Ears, Nose and Throat: cataract; conjunctivitis.

Gastrointestinal: constipation; vomiting.

Genitourinary: frequent urination.

Hematologic: anemia.

Muskuloskeletal: back pain.

Psychiatric: hallucinations; agitation.

Respiratory: cough; shortness of breath; pneumonia.

Common side-effects of Memantine

Dizziness, headache, constipation.

Rare but serious side-effects of note of Memantine

  • Seizures

Memantine overdose

Loss of consciousness, psychosis, restlessness, somnolence, stupor, visual hallucinations.

Memantine and pregnancy

Category B: animal studies have not shown any adverse effects at very high doses, but no controlled human studies have been done; should only be used in pregnancy if clearly needed and if benefits outweigh potential risks.

Medical Monitoring for Memantine

None for healthy individuals.

Drug Interactions with Memantine

  • Use caution when combining Memantine with other NMDA antagonists such as Amantadine, Dextromethorphan, and Ketamine.
  • Memantine levels may be increased by drugs that increase urine pH, such as carbonic anhydrase inhibitors and sodium bicarbonate.