Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist. It is available in the US as Namenda® (brand name and generic), Namenda XR® (brand name only), and Namzaric® (in combination with donepezil; brand name only). Here is basic information about this medication.
Memantine (Namenda®)
FDA-approved indications
Treatment of moderate to severe dementia of the Alzheimer’s type
Dosage
Starting: 5 mg once daily
Maintenance: Increase in 5 mg increments with minimum interval of one week between dose increases to recommended maintenance dose of 10 mg twice daily
Special Populations
In patients with severe renal impairment (Creatinine clearance 5 to 29 mL/min)
Recommended maintenance dose is 5 mg twice daily
Dosage forms and strengths
Tablet: 5 mg and 10 mg
Oral solution: 2 mg/mL
Please refer to Prescribing Information (see link below) for a complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Memantine (Namenda XR®) extended-release capsules
FDA-approved indications
Treatment of moderate to severe dementia of the Alzheimer’s type
Dosage
Starting: 7 mg once daily
Maintenance: Increase in 7 mg increments with minimum interval of one week between dose increases to recommended maintenance dose of 28 mg once daily
Maximum: 28 mg once daily
Special Populations
In patients with severe renal impairment (Creatinine Clearance 5-29 mL/min): Recommended maintenance dose is 14 mg/day
In patients switching from memantine (Namenda®) to memantine extended-release (Namenda XR®)
Patients on a regimen of Namenda® 10 mg twice daily may be switched to Namenda XR® 28 mg once daily following the last dose of 10 mg Namenda®.
In patients with severe renal impairment who are on a regimen of Namenda® 5 mg twice daily may be switched to Namenda XR® 14 mg once daily following the last dose of 5 mg Namenda®.
Instructions
Can be taken with or without food
Capsules may be opened, sprinkled on applesauce, and thereby swallowed
Capsule has to be swallowed whole and should not be divided, chewed, or crushed
If a patient misses a single dose, patient should take up the next dose as scheduled without doubling the dose
If a patient fails to take Namenda XR® for several days, dosing may need to be resumed at lower doses
Dosage forms and strengths
Extended-Release capsule (Namenda XR®): 7 mg, 14 mg, 21 mg, and 28 mg
Please refer to Prescribing Information (see link below) for a complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Memantine and donepezil (Namzaric®) extended-release
Namzaric® is a combination of memantine hydrochloride, an NMDA receptor antagonist, and donepezil hydrochloride, an acetylcholinesterase inhibitor.
FDA-approved indications
Treatment of moderate to severe dementia of the Alzheimer’s type in patients stabilized on 10 mg of donepezil once daily
Dosage
1. For patients stabilized on donepezil 10 mg daily
Starting: 7 mg/10 mg (memantine/donepezil) taken once daily in the evening
Titration: Increase dosage in 7 mg increments with a minimum interval of at least one week between dose increases.
Maximum: 28 mg/10 mg
2. For patients stabilized on both memantine (10 mg twice daily or 28 mg extended-release once daily) and donepezil (10 mg once daily)
Switch to Namzaric® 28 mg/10 mg, taken once daily in the evening
3. In patients with severe renal impairment
Recommended maintenance dose is 14 mg/10 mg once daily in the evening
Instructions May be taken with or without food, whole or sprinkled on applesauce
Capsule should not be divided, chewed, or crushed
Dosage forms and strengths
Extended-Release Capsules:
7 mg memantine hydrochloride and 10 mg donepezil hydrochloride
14 mg memantine hydrochloride and 10 mg donepezil hydrochloride
21 mg memantine hydrochloride and 10 mg donepezil hydrochloride
28 mg memantine hydrochloride and 10 mg donepezil hydrochloride
Please refer to Prescribing Information (see link below) for a complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Related Pages
Tips for interviewing patients with dementia
Neuroimaging in persons with dementia
Key points from the APA Practice Guideline on the Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia
Neurocognitive disorders: Classification (Free)
Cognitive Enhancers: Index and Links
Neurocognitive disorders: Index and Links
References
Memantine (Namenda®) prescribing information
Memantine (Namenda XR®) extended-release prescribing information
Memantine and donepezil (Namzaric®) extended-release capsules prescribing information
Copyright 2016, Rajnish Mago, MD. All rights reserved. May not be reproduced in any form without express written permission.
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