Memantal tabs 10mg #90

Memantal user manual

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Composition

1 tablet contains:
Active ingredient: memantine hydrochloride 10 mg;
Excipients: lactose monohydrate - 149.75 mg; MCC - 27.1 mg; talc - 11.15 mg; colloidal silicon dioxide - 1.25 mg; magnesium stearate - 0.75 mg.
Packaging - 90 pieces

pharmachologic effect

Memantal - cerebrovasodilating, psychostimulating, antihypoxic, nootropic.

Pharmacodynamics

It has a nootropic, cerebrovasodilating, antihypoxic and psychostimulating action. Blocks glutamate N-methyl-D-aspartate receptors (NMDA-receptors), including in the substantia nigra, thereby reducing the excessive stimulating effect of cortical glutamate neurons on the neostriatum, which develops against the background of insufficient release of dopamine. Reducing the flow of ionized calcium into neurons, reduces the possibility of their destruction. Mostly affects stiffness (rigidity and bradykinesia). Improves weakened memory, concentration, reduces fatigue and symptoms of depression, spasticity caused by diseases and injuries of the brain.

Pharmacokinetics

After oral administration, memantine is rapidly and completely absorbed from the gastrointestinal tract. Tmax in blood plasma - 2–6 hours. With normal renal function, cumulation of memantine is not observed. Withdrawal proceeds in two phases. T1 / 2 averages 4–9 h in phase 1, 40–65 h in phase 2. About 80% of memantine is excreted unchanged. Metabolites do not possess their own pharmacological activity. Excreted in the urine. With alkaline urine, excretion slows down.

Memantal, indications for use

Dementia moderate and severe severity of Alzheimer's disease.

Contraindications

    hypersensitivity to Memantal;
    severe renal impairment (Cl creatinine
    severe liver failure;
    lactose intolerance, Lappa lactase deficiency or glucose-galactose malabsorption (the product contains lactose monohydrate);
    pregnancy;
    breast-feeding;
    children's age up to 18 years (efficiency and safety are not established).
With care: thyrotoxicosis; epilepsy; convulsions (including in history); simultaneous use of other antagonists of NMDA receptors (amantadine, ketamine, dextromethorphan); the presence of factors that increase the pH of urine (abrupt change of diet, receiving large quantities of alkaline gastric buffers); severe urinary tract infections; history of myocardial infarction; heart failure of the III – IV functional class (according to the NYHA classification); uncontrolled arterial hypertension; renal and hepatic failure.

Dosage and administration

Inside, once a day, at the same time, regardless of the meal.
Dosing regimen set individually. It is recommended to begin treatment with the appointment of the minimum effective dose. Prescribe Memantal during the 1st week of therapy (days 1-7) at a dose of 5 mg / day, during the 2nd week (days 8-14) - at a dose of 10 mg / day, during the 3rd week (days 15 –21) - at a dose of 15 mg / day, for 4 weeks (days 22–28) - at a dose of 20 mg / day. Maximum daily dose is 20 mg.

Special patient groups

Patients older than 65 years, as well as in patients with Cl creatinine 50–80 ml / min, do not require dose adjustment. In patients with moderate renal insufficiency (Cl creatinine 30–49 ml / min), the daily dose is 10 mg. In the future, with good tolerability of Memantal for 7 weeks, the dose can be increased to 20 mg according to the standard scheme.

Side effects of Memantal

From the side of the central nervous system: often - headache, drowsiness, dizziness; rarely - confusion, hallucinations (mainly in patients with Alzheimer's disease at the stage of severe dementia), gait disturbance; very rarely - seizures; frequency not established - psychotic reactions.
On the part of the digestive system: often - constipation; rarely - nausea, vomiting; frequency is not installed - pancreatitis.
From the side of the cardiovascular system: rarely - arterial hypertension, venous thrombosis / thromboembolism.
Other: rarely - fatigue, fungal infections.
There are separate reports of the occurrence of these adverse reactions when Memantal is used in clinical practice: dizziness, drowsiness, anxiety, fatigue, anxiety, increased ICP, nausea, hallucinations, headache, impaired consciousness, muscle tone, gait disturbances, depression, convulsions, psychotic reactions, suicidal thoughts, constipation, nausea, pancreatitis, candidiasis, increased blood pressure, vomiting, cystitis, increased libido, venous thrombosis, thromboembolism, allergic reactions.

special instructions

Influence on ability to steer vehicles and work with mechanisms. Patients with Alzheimer's disease at the stage of moderate or severe dementia usually have impaired ability to drive vehicles and manage complex mechanisms. In addition, memantine can cause a change in the reaction rate, so patients should refrain from driving or working with complex mechanisms.

Interaction

Enhances the effect of levodopa preparations, dopamine receptor antagonists, m-holinoblokatorov.
Reduces the effect of barbiturates and neuroleptics.
Changes (strengthens or reduces) the effect of dantrolene or baclofen, so the doses of drugs should be selected individually.
Concurrent use with amantadine, ketamine, phenytoin and dextromethorphan should be avoided due to the increased risk of developing psychosis.
An increase in plasma concentrations of cimetidine, ranitidine, procainamide, quinidine, quinine and nicotine is possible.
Decrease in level of a hydrochlorothiazide is possible. Memantine is able to increase the excretion of hydrochlorothiazide.
Perhaps an increase in MHO in patients taking oral anticoagulants (warfarin).
Simultaneous use with antidepressants, SSRIs and MAO inhibitors requires careful monitoring of patients.

Storage conditions

Shelf life - 3 years
At a temperature not higher than 25 ° C.

Terms of sell

You don't need a prescription to buy Memantal.