Memantine Canon, 20 mg 90 pcs

A treatment for dementia. It is a non-competitive antagonist of glutamate NMDA-receptors (including in the substantia nigra), due to this it reduces excessive stimulating effect of cortical glutamate neurons on neostriatum, which develops on the background of insufficient dopamine release. By reducing the Ca2+ influx into the neurons, it reduces the possibility of their destruction.

It has nootropic, cerebrovasodilatory, antihypoxic and psychostimulatory effects.

It improves impaired memory, increases ability to concentrate, reduces fatigue and symptoms of depression, reduces spasticity of skeletal muscles caused by brain disease or damage.

Pharmacokinetics

After oral administration, it is rapidly and completely absorbed from the GI tract. Cmax is reached after 3-8 hours. Binding to plasma proteins is 45%. Css of 70 to 150 ng/ml is achieved when administered at a dose of 20 mg/day. Vd is 10 l/kg. Partially metabolized in the liver. It is excreted by the kidneys. T1/2 is 60-100 h; clearance is 170 ml/min/1.73 m2.

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Indications

Medium to severe dementia in Alzheimer’s disease.

Active ingredient

Composition

White or almost white film-coated tablets, round, biconvex; cross-section is almost white.

1 tablet

Membrane hydrochloride 20 mg

Excipients:

calcium hydrophosphate dihydrate – 55 mg,

colloidal silicon dioxide – 5.2 mg,

croscarmellose sodium – 7.5 mg,

lactose monohydrate – 161.1 mg,

magnesium stearate – 1.8 mg,

povidone K30 – 9.4 mg.

Content of film coating:

White opadray – 8 mg, including. Hypromellose (hydroxypropyl cellulose) – 2.7 mg, hyprolose (hydroxypropyl cellulose) – 2.7 mg, talc – 1.6 mg, titanium dioxide – 1 mg.

How to take, the dosage

In case of oral administration, the initial dose for adults is 5 mg/day. Thereafter, the dose may be increased weekly by 5 mg. The average maintenance dose is 10-20 mg/day. Maximal dose is 20 mg/day.

Interaction

When used concomitantly, memantine may reduce the effects of barbiturates and neuroleptics.

The effects of baclofen and dantrolene may be altered by memantine (doses may need to be adjusted for this combination).

The effects of levodopa, dopamine receptor agonists and anticholinergic agents are enhanced with concomitant use of NMDA-receptor antagonists.

Because memantine and amantadine are NMDA receptor antagonists, concomitant use should be avoided due to the risk of toxic effects.

Combinations of memantine with ketamine, dextromethorphan and phenytoin are also potentially toxic.

The same renal cation system is used for the transport of amantadine, cimetidine, ranitidine, quinidine and nicotine in the body, which may cause interaction of these drugs with memantine, resulting in increased plasma concentrations.

When used concomitantly, memantine can cause a decrease in the serum concentration of hydrochlorothiazide.

Concomitant use with warfarin and other indirect anticoagulants requires close monitoring of prothrombin time and INR.

Special Instructions

Caution should be exercised in patients with epilepsy, renal insufficiency, thyrotoxicosis, history of seizures, arterial hypertension, history of myocardial infarction, heart failure.

In case of impaired renal function, the dose of memantine should be reduced.

Contraindications

Severe hepatic impairment; pregnancy; lactation (breastfeeding) period; childhood and adolescence under 18 years of age (effectiveness and safety of the drug have not been studied); hypersensitivity to memantine.

Side effects

Nervous system disorders: Dizziness, headache, drowsiness, gait disturbance, confusion, hallucinations, seizures, psychosis, hyperexcitability.

Digestive system disorders: constipation, vomiting, nausea, pancreatitis.

Cardiovascular system side: High blood pressure, venous thrombosis, thromboembolism.

From the body in general:fungal infections, general weakness, increased fatigue, allergic reactions.

Overdose

Symptoms

In cases of overdose of less than 140 mg once or when an unknown dose was taken, patients have had adverse reactions from the central nervous system: confusion, hypersomnia, drowsiness, dizziness, agitation, aggression, hallucinations, gait disturbances; and cardiovascular disorders: vomiting, diarrhea.

In relatively large overdoses (200 mg once and 105 mg/day for 3 days) the following symptoms were observed: fatigue, weakness, and/or diarrhea or no symptoms.

In the most severe case of overdose, the patient survived the 2000 mg dose of memantine and had central nervous system adverse reactions (coma for 10 days, followed by diplopia and agitation). The patient received symptomatic treatment and plasmapheresis. The patient recovered without further complications.

In another case of a severe overdose, the patient survived and recovered after receiving memantine at a dose of 400 mg once. The patient experienced central nervous system adverse reactions: anxiety, psychosis, visual hallucinations, decreased seizure threshold, drowsiness, stupor, and loss of consciousness.

Treatment

There is no specific antidote for memantine intoxication. Standard measures aimed at removing the drug from the body should be carried out: gastric lavage, activated charcoal administration, conducting forced diuresis, increasing the acidity of the urine.

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