Memorel tabs 10mg #30

Memorel user manual

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Composition

1 tablet contains:
Active ingredient: memantine hydrochloride 10 mg
Excipients: lactose monohydrate - 192.5 mg; Siliconized microcrystalline cellulose (MCC - 36.75 mg, colloidal silicon dioxide - 0.75 mg) - 37.5 mg; talc - 2.5 mg; magnesium stearate - 2.5 mg
Film casing: Opadry OY-S-28959 white (hypromellose (hydroxypropyl methylcellulose) - 3.125 mg, titanium dioxide - 1.5625 mg, triacetin - 0.3125 mg) - 5 mg
Packaging - 30, 60 and 90 pcs.

pharmachologic effect

Memorel - a blocker of glutamate NMDA receptors. Drug for the treatment of dementia. It has nootropic, cerebrovasodilating, antihypoxic and psychostimulating action.
Adamantane derivative, by chemical structure and pharmacological properties similar to amantadine. It blocks glutamate N-methyl-D-aspartate (NMDA) receptors (including in the black substance), 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).
In addition to the action on the central nervous system, memantine affects efferent innervation. Improves weakened memory, concentration, reduces fatigue and symptoms of depression, reduces spasticity of skeletal muscles caused by diseases and injuries of the brain, increases daily activity.

PHARMACOKINETICS

Suction

After ingestion quickly and completely absorbed from the digestive tract. Cmax is reached after 3-8 hours. Eating does not affect the absorption of Memorel.

Distribution

Taking Memorel in a daily dose of 20 mg leads to a Css of 70 to 150 mg / ml. Vd is about 10 l / kg. Plasma protein binding - 45%. In normal renal function, cumulation of memantine is not observed.

Metabolism

80% of memantine circulating in the blood is represented by unchanged substance. Metabolism proceeds without the participation of cytochrome P450. The major metabolites are N-3,5-dimethylgludantan, an isomeric mixture of 4- and 6-hydroxymemantin, and 1-nitroso-3,5-dimethyladamantane. None of the metabolites has antagonistic activity against NMDA receptors.

Removal

Excreted mainly by the kidneys. Removal occurs in single phase, T1 / 2 is 60-100 h; clearance is 170 ml / min / 1.73 m2, partly secreted by the renal tubules. With alkaline urine, the excretion of Memorel slows down (on average by 80% with a urine pH of 8).

Memorel, indications for use

Dementia moderate and severe severity of Alzheimer's disease.

Contraindications

    severe liver failure;
    lactose intolerance, lactase deficiency;
    glucose-galactose malabsorption syndrome (the product contains lactose);
    pregnancy;
    lactation;
    age up to 18 years;
    hypersensitivity to Memorel components.
With care: thyrotoxicosis, epilepsy, renal failure, convulsions in history, arterial hypertension, myocardial infarction in history, heart failure.

Dosage and administration

Inside, regardless of the meal.
During the 1st week the daily dose is 5 mg of Memorel (in the morning). At the 2nd week, the daily dose is 10 mg (5 mg 2 times a day). During the 3rd week, the daily dose is 15 mg per day (10 mg in the morning and 5 mg in the evening). From the 4th week, the daily dose is 20 mg per day. The maximum daily dose is 20 mg per day.
Dose adjustment in elderly patients (over 65 years) is not required.
In moderate renal failure (Cl creatinine 50–80 ml / min), dose adjustment is usually not required; with Cl creatinine 30–49 ml / min, the daily dose initially does not exceed 10 mg, then after 7 days, provided the tolerance is good, the dose can be increased up to 20 mg. In severe renal insufficiency (Cl creatinine 5–29 ml / min), the daily dose should not exceed 10 mg.
With mild and moderate liver failure (class A and B according to Child-Pugh classification), dose adjustment is not required.

Use during pregnancy and lactation

Memantine has the ability to slow the development of the fetus. At the time of treatment with memantine, breastfeeding should be interrupted.

Side effects of Memorel

On the part of the nervous system: dizziness, headache, drowsiness, gait disturbance, confusion, hallucinations, convulsions, psychosis, irritability.
On the part of the digestive system: constipation, vomiting, pancreatitis, nausea.
Infections and invasions: fungal infections.
Since the cardiovascular system: increased blood pressure, venous thrombosis, thromboembolism.
On the part of the body as a whole: general weakness, fatigue, allergic reactions.

special instructions

With alkaline urine, more careful monitoring of these patients is required due to slower removal of memantine.
Influence on ability to drive motor transport and control mechanisms
Care should be taken when driving and performing work that require high concentration of attention.

Interaction

With simultaneous use can weaken the effect of barbiturates and neuroleptics.
The action of baclofen and dantrolene may change under the influence of memantine, so you may need to adjust their doses.
With simultaneous use of memantine with levodopa preparations, dopamine agonists, anticholinergic agents, the action of the latter can be enhanced.
Due to the fact that memantine and amantadine are NMDA receptor antagonists, simultaneous use should be avoided due to the risk of developing toxic effects. Combinations of memantine with ketamine, dextromethorphan and phenytoin are also potentially toxic.
For the transport of amantadine, zimetidine, ranitidine, quinidine, procainamide, quinine and nicotine in the body, the same renal cationic system is used, which may cause the interaction of these drugs with memantine, leading to an increase in its plasma concentration.
With simultaneous use of memantine may cause a decrease in the concentration of hydrochlorothiazide in the serum.
At simultaneous use with warfarnny and other indirect anticoagulants careful control of a prothrombin time and the international normalized relation is required.

Overdose

Symptoms: dizziness, tremor, agitation, drowsiness, dullness, agitation, stupor, convulsions, aggressiveness, hallucinations, instability of gait, vomiting, diarrhea.
Treatment: gastric lavage, the appointment of activated carbon; symptomatic therapy. There is no specific antidote. Removal of Memorel can be accelerated by acidifying the urine.
Shelf life - 2 years.

Storage conditions

To store a preparation in the dry, protected from light place at a temperature not above 25 ° C.

Terms of sell

You can buy Memorel without a prescription.