Galantamine
Indications
Galantamine is used for:
Dementia in Alzheimer's disease.
Adult Dose
Alzheimer Disease
Initial
4 mg PO q12hr
Maintenance
Titrate to 8-12 mg PO q12hr; increase by 4 mg q12hr at no less than 4 week intervals
Hepatic Impairment
Moderate: (Child-Pugh score 7-9): Not to exceed 16 mg/day
Severe: Not recommended
Child Dose
Not recommended
Renal Dose
Renal Impairment
Moderate: Not to exceed 16 mg/day
Severe (CrCl <9 mL/min): Not recommended
Administration
Should be taken with food.
Contra Indications
Hypersensitivity; severe liver or kidney dysfunction; lactation; disorders of galactose metabolism; urinary retention or GI obstruction. Lactation.
Precautions
Mild-moderate hepatic impairment; supraventricular conduction abnormalities; asthma; COPD; pregnancy; peptic ulcers. May increase gastric acid production.
Pregnancy-Lactation
Pregnancy Category: B
Lactation: unknown
Interactions
ncreased serum concentrations when used with drugs that inhibit CYP2D6 (e.g. quinidine, fluoxetine, fluvoxamine, and paroxetine) and CYP3A4 (e.g. ketoconazole and ritonavir). Cimetidine may increase the bioavailability of galantamine. Increased risk of gastric ulcer when used with NSAIDs.
Potentially Fatal: Amiodarone, ?-blockers, diltiazem or verapamil; NSAIDs; digoxin.
Adverse Effects
Side effects of Galantamine :
>10%
Nausea (20-25%), Diarrhea (11-15%), Vomiting (11-15%)
1-10%
Abdominal pain, Anorexia, Muscle cramp, Fatigue, Dizziness, Headache, Weight loss, Depression, Insomnia, UTI, Somnolence, Anemia, Syncope, Bradycardia
Potentially Fatal: CV effects; convulsion; delirium; rectal haemorrhage; thrombocytopenia.
Mechanism of Action
Galantamine is a centrally-acting cholinesterase inhibitor, elevating acetylcholine in the cerebral cortex. Glutamine and serotonin levels may also be increase. It has nicotinic receptor agonist properties.