galantamine

Generic Name: galantamine (ga LAN ta meen)Brand names: Razadyne, Razadyne ER, Reminyl

What is galantamine?

Galantamine improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.

Galantamine is used to treat mild to moderate dementia caused by Alzheimer's disease.

Galantamine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about galantamine?

Before taking galantamine, tell your doctor if you are allergic to any drugs, or if you have urination problems, heart disease, a heart rhythm disorder, stomach ulcers or bleeding, a seizure disorder, kidney disease, liver disease, or asthma.

Stop using galantamine and call your doctor at once if you have chest pain, slow heart rate, blood in your stools, coughing up blood, decreased urination, weakness, confusion, extreme thirst, or hot, dry skin.

There are many other medicines that can interact with galantamine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking galantamine. You may need to stop using the medicine for a short time.

If you have stopped taking galantamine for any reason, talk with your doctor before you start taking it again. You may need to restart the medication at a lower dose. Galantamine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my healthcare provider before taking galantamine?

Do not use this medication if you are allergic to galantamine.

Before taking galantamine, tell your doctor if you are allergic to any drugs, or if you have:

• urination problems;

• heart disease or a heart rhythm disorder;

• a history of stomach ulcer or bleeding;

• seizures or epilepsy;

• kidney disease;
• liver disease; or

• a history of asthma or obstructive pulmonary disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take galantamine.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether galantamine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take galantamine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Galantamine is usually taken once or twice a day with a meal. You may also take the medication without food. Follow your doctor's instructions.

Do not crush, chew, break, or open an extended-release capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time. Take the capsule or tablet with a full glass of water. Drink 6 to 8 full glasses of water each day to keep from getting dehydrated while taking galantamine.

The liquid form of this medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Measure the liquid using only the special dose-measuring device provided. Empty the medicine into 3 to 4 ounces of any non-alcoholic beverage. Stir this mixture and drink all of it right away. Rinse the dose-measuring device with water after each use.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking galantamine. You may need to stop using the medicine for a short time.

If you have stopped taking galantamine for any reason, talk with your doctor before you start taking it again. You may need to restart the medication at a lower dose. Store galantamine at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.

See also: Galantamine dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include severe nausea, vomiting, stomach cramps, muscle weakness or spasm, watery eyes, drooling, increased urination or bowel movements, sweating, slow heart rate, feeling light-headed or fainting, and seizure (convulsions).

What should I avoid while taking galantamine?

Galantamine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Galantamine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using galantamine and call your doctor at once if you have any of these serious side effects:

• chest pain, slow heart rate;

• black, bloody, or tarry stools;

• coughing up blood or vomit that looks like coffee grounds;

• weakness, confusion, decreased sweating, extreme thirst, hot dry skin; or

• urinating less than usual or not at all.

Less serious side effects may include:

• feeling tired, dizzy, or light-headed;

• nausea, vomiting, gas, loss of appetite;

• weight loss; or

• headache.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Galantamine Dosing Information

Usual Adult Dose for Alzheimer's Disease:

Immediate Release:Initial dose: 4 mg orally twice a day, preferably with morning and evening meals. After a minimum of four weeks of treatment, if the initial dosage is well tolerated, it should be increased to 8 mg twice a day. A further increase to 12 mg twice a day should be attempted only after a minimum of 4 weeks at the previous dosage.If therapy has been interrupted for several days or longer, the patient should be restarted at the lowest dosage. Treatment may then be escalated back up to the dosage the patient was receiving when therapy was interrupted.The dosage of galantamine shown to be effective in controlled clinical trials is 8 to 16 mg twice daily. However, the dosage at the upper end is less well tolerated than lower ones and does not yield improved efficacy, thus the recommended dose range is 8 to 12 mg twice a day. The 12 mg twice a day dosage was not associated with a statistically significant clinical improvement over the lower dosage in clinical studies but may offer additional benefit for some patients.Extended Release Capsules:Initial dose: 8 mg orally daily, preferably with the morning meal. After a minimum of four weeks of treatment, if the initial dosage is well tolerated, it should be increased to 16 mg once a day. A further increase to 24 mg once a day should be attempted only after a minimum of 4 weeks at the previous dosage. Dose increases should be based upon assessment of clinical benefit and tolerability of the previous dose.If therapy has been interrupted for several days or longer, the patient should be restarted at the lowest dosage. Treatment may then be escalated back up to the dosage the patient was receiving when therapy was interrupted.

What other drugs will affect galantamine?

Before taking galantamine, tell your doctor if you are using any of the following drugs:

• atropine (Donnatal, and others);

• belladonna;

• clidinium (Quarzan);

• dicyclomine (Bentyl);

• glycopyrrolate (Robinul);

• hyoscyamine (Anaspaz, Cystospaz, Levsin, and others);

• ketoconazole (Nizoral);

• mepenzolate (Cantil);

• methantheline (Provocholine);

• methscopolamine (Pamine);

• paroxetine (Paxil, Pexeva);

• propantheline (Pro-Banthine); or

• scopolamine (Transderm-Scop).

This list is not complete and there may be other drugs that can interact with galantamine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about galantamine.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 4.02. Revision Date: 4/12/2009 4:44:36 PM.