Memantine

• Memantine given in high doses to pregnant rats and rabbits did not affect the offspring. However, studies have not been conducted in pregnant women. Memantine should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus.
• It is not known if memantine is excreted into breast milk.

• Tablets: 5 and 10 mg.
• Capsule (extended release): 7, 14, 21 and 28 mg.
• Solution: 2 mg/ml.

Tablets should be stored at room temperature, 15 C - 30 C (59 F - 86 F).

Namenda comes as a liquid or extended-release capsule to take by mouth. The liquid is typically taken once or twice a day with or without food. The capsule is taken once a day with or without food.

The recommended starting dose of Namenda is 5 milligrams (mg) a day. The recommended target dose is 20 mg a day.

You shouldn't crush, divide, or chew the capsules. You should try to swallow them whole with a full glass of water. However, if you can't, carefully open a capsule and place the contents on a spoonful of applesauce. Swallow the applesauce without chewing.

Don't mix the liquid form of Namenda with any other liquids.

Your doctor will probably start you on a low dose of Namenda and gradually increase it. You should follow the directions on your prescription label carefully. Don't take more or less of this drug than is prescribed.

Namenda Overdose

If you suspect an overdose, you should contact a poison control center or emergency room immediately. You can get in touch with a poison control center at (800) 222-1222.

Missed Dose of Namenda

If you miss a dose of Namenda, take it as soon as you remember. However, if it's almost time for your next dose, skip the missed dose and continue on your regular dosing schedule.

Don't double up on doses to make up for a missed one. If you miss several days of Namenda, call your doctor to discuss how to start taking the medication again.

Memantine is a prescription medication used to treat the symptoms of Alzheimer's disease.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Memantine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• extreme tiredness 
• dizziness 
• confusion 
• headache 
• sleepiness 
• constipation 
• vomiting 
• pain anywhere in your body, especially your back 
• coughing

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately: 

• shortness of breath 
• hallucination (seeing things or hearing voices that do not exist)

Memantine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Before taking memantine, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to memantine or any other medications
• have or have ever had asthma, seizures, kidney disease, or repeated urinary tract infections
• re pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking memantine, call your doctor. 
• are having surgery, including dental surgery, tell the doctor or dentist that you are taking memantine
• use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.

Memantine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

• Store memantine between 15-30°C (59-86°F).
• Store memantine XR capsules between 68°F to 77°F (20°C to 25°C).
• Do not use memantine after the expiration date shown on the carton and bottle.
• Keep this and all medicines out of the reach of children.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• severe headache, blurred vision, pounding in your neck or ears;

• seizure (convulsions); or

• unusual changes in mood or behavior.

Common side effects may include:

• diarrhea;

• dizziness; or

• headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In the U.S.

• Namenda
• Namenda XR
• Namenda XR Titration Pack

Available Dosage Forms:

• Capsule, Extended Release
• Tablet
• Solution

Therapeutic Class: Central Nervous System Agent

Pharmacologic Class: N-Methyl-D-Aspartate Receptor Antagonist

Take memantine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

memantine comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

You may take memantine with or without food.

Swallow the extended-release capsules whole. Do not break, crush, or chew them.

If you cannot swallow the extended-release capsule, you may open it and pour the medicine into a small amount of soft food such as applesauce. Stir this mixture well and swallow it without chewing.

For patients taking the oral liquid:

• Remove the oral dosing syringe along with the cap and plastic tube from the bag and attach to tube to the cap.
• Open the child-resistant cap on the bottle by pushing down on the cap while turning the cap counter-clockwise (to the left) and remove the cap and seal from the bottle.
• Insert the plastic tube fully into the bottle and screw the cap tightly onto the bottle by turning the cap clockwise (to the right).
• Keeping the bottle upright on the table, remove the lid to uncover the opening on the top of the cap. With the plunger fully depressed, insert the tip of the syringe firmly into the opening of the cap.
• While holding the syringe, gently pull the plunger of the syringe up to draw medicine into the syringe.
• Remove the syringe from the cap opening. Invert the syringe (point tip upwards) and slowly press the plunger to a level that pushed out any large air bubbles that may be present. Keep the plunger in this position.
• Re-insert the tip of the syringe into the cap opening. While holding the syringe, continue to gently pull out the plunger until the bottom of the black ring of the plunger reaches the appropriate mark on the syringe that corresponds to the dose prescribed.
• Remove the syringe from the bottle and swallow the oral solution directly from the syringe. Do not mix with any other liquid.
• After use, reseal the bottle by snapping the attached lid closed.
• Rinse the empty syringe by inserting the open end of the syringe into a glass of water, pulling the plunger out to draw in water, and pushing the plunger in to remove the water. Repeat several times. Allow the syringe to air dry.

Dosing

The dose of memantine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of memantine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For treatment of Alzheimer's disease:
  • For oral dosage form (extended-release capsules):
    • Adults—At first, 7 milligrams (mg) once a day. Your doctor may gradually increase your dose as needed. However, the dose is usually not more than 28 mg per day.
    • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (solution and tablets):
    • Adults—At first, 5 milligrams (mg) once a day. Your doctor may gradually increase your dose as needed. However, the dose is usually not more than 10 mg two times a day.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of memantine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

It is very important that your doctor check your progress at regular visits to make sure that memantine is working properly and to check for unwanted effects.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

(me MAN teen)

• Memantine HCl
• Memantine Hydrochloride

Alzheimer disease: Treatment of moderate to severe dementia of the Alzheimer type.

Refer to adult dosing.

Mild-to-moderate impairment: No dosage adjustment necessary.

Severe impairment:

U.S. labeling: There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied); use with caution.

Canadian labeling: There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied); use is not recommended.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.