Buy MEMANTAL pills 10 mg 90 pcs
  • Buy MEMANTAL pills 10 mg 90 pcs

Memantine

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2019-09-19
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Clinical Pharmacology

It has nootropic, cerebrovasodilating, antihypoxic and self-stimulating action. Derived admantane, the chemical structure and pharmacological properties similar to amantadine. It blocks glutamate N-methyl-D-aspartate receptors (NMDA receptors) (including the substantia nigra), thereby reducing the excessive stimulating effect of cortical glutamate neurons on the naneostratum that develops against the background of insufficient release of dopamine. Reducing the flow of ionized calcium into neurons, reduces the possibility of their destruction. Mostly affects stiffness (rigidity and bradykinesia). Improves weakened memory, concentration, reduces fatigue and symptoms of depression, reduces spasticity caused by diseases and injuries of the brain.

Indications

- dementia of Alzheimer's type of moderate and severe.

Composition

memantine hydrochloride 10.00 mg;

excipients: tablet core - lactose monohydrate 149.75 mg, microcrystalline cellulose 27.10 mg, talc 11.15 mg, colloidal silicon dioxide 1.25 mg, magnesium stearate 0.75 mg; shell - White opadry (lactose monohydrate 2.16 mg, hypromellose 1.68 mg, titanium dioxide 1.56 mg, macrogol-4000 0.60 mg) - 6.00 mg.


Memantine is marketed under different brands and generic names, and comes in different dosage forms:

Brand nameManufacturerCountryDosage form
MEMANTAL Sinton Spain S.L Spain pills
Memantine Canonpharma Russia pills
Noodgeron Teva Israel pills
MEMANTINOL Geropharm Russia pills
Akatinol Memantine Merz Germany pills
Maruxa® Krka dd Novo mesto AO Slovenia pills
Memorial Bilim Ilyach Sanayii ve Tijaret Turkey pills
Akatinol Memantine Merz Germany Other

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Memantine

Dosage and Administration

Therapy should be carried out under the supervision of a physician with expertise in the diagnosis and treatment of dementia in Alzheimer's disease. Therapy should be initiated only if the person providing regular patient care will monitor the patient's drug intake. The diagnosis should be made in accordance with the current recommendations.

Tolerability and dose of the drug should be regularly assessed, mainly within three months after the start of therapy. Then you should regularly evaluate the clinical efficacy of the drug and the tolerability of therapy in accordance with the current clinical guidelines. Maintenance therapy can continue indefinitely with a therapeutic effect and good tolerability of the drug. The drug should be discontinued if the therapeutic effect is no longer observed or if the patient does not tolerate treatment.

The drug is taken orally, 1 time / day, always at the same time, regardless of the meal. Dosing regimen set individually. It is recommended to begin treatment with the appointment of the minimum effective dose.

Prescribe the drug during the 1st week of therapy (days 1-7) at a dose of 5 mg / day, during the 2nd week (days 8-14) - at a dose of 10 mg / day, during the 3rd week (days 15-21) - at a dose of 15 mg / day, during the 4th week (days 22-28) - at a dose of 20 mg / day. The maximum daily dose of 20 mg.

In patients older than 65 years, as well as in patients with CC 50-80 ml / min, dose adjustment is not required. For patients with moderate renal insufficiency (CK 30-49 ml / min), the daily dose is 10 mg. In the future, with good tolerability of the drug for 7 weeks, the dose can be increased to 20 mg according to the standard scheme.

Instructions for dividing the tablet

Place the tablet with the rounded side face up on a hard surface. Press the index and thumb of one hand on the opposite sides of the tablet, continue to apply pressure with your fingers until the tablet breaks into two pieces.

Adverse reactions

The incidence of adverse reactions was classified as follows: very often (≥1 / 10), often (≥1 / 100, <1/10). infrequently (≥1 / 1000, <1/100), rarely (≥1 / 10 000, <1/1000), very rarely (<1/10 000), the frequency has not been established (currently there are no data on the prevalence of adverse reactions ).

Infectious and parasitic diseases: infrequently - fungal infections.

On the part of the immune system: often - hypersensitivity to memantine or other components that make up the drug.

Psychiatric disorders: infrequently - confusion, hallucinations (mainly in patients with severe Alzheimer's disease); frequency not established - psychotic reactions.

On the part of the nervous system: often - headache, drowsiness, dizziness, imbalance; infrequently - gait disturbance: very rarely - convulsions, epileptic seizures.

From the side of the heart: infrequently - heart failure, heart defects.

On the part of the vessels: often - increased blood pressure, venous thrombosis and / or thromboembolism.

The respiratory system, organs of the chest and mediastinum: often - shortness of breath.

On the part of the digestive tract: often - constipation; rarely - nausea, vomiting; frequency is not installed - pancreatitis.

Liver and biliary tract: often - impaired liver function tests.

Other: infrequently - fatigue, weakness.

In Alzheimer's disease, patients in post-registration studies reported depression, suicidal thoughts and suicide cases.

In the post-marketing period, the following adverse reactions were reported: agranulocytosis, leukopenia (including neutropenia), pancytopenia, thrombocytopenia, thrombocytopenic purpura, hepatitis, acute renal failure, Stevens-Johnson syndrome.

Contraindications

- individual hypersensitivity to the drug;

- severe renal dysfunction (CC less than 5-29 ml / min);

- severe liver failure;

- pregnancy;

- breast-feeding;

- children's age up to 18 years (efficiency and safety are not established);

- lactose intolerance, lactase deficiency lapp or glucose-galactose malabsorption (the product contains lactose monohydrate).

With caution prescribed to patients with thyrotoxicosis, epilepsy; predisposition to the development of seizures; simultaneous use of NMDA receptor antagonists (amantadine, ketamine, dextromethorphan), the presence of factors that increase urine pH (abrupt diet change, abundant intake of alkaline gastric buffers), renal canalicular acidosis, severe urinary tract infections, myocardial infarction in history, heart failure III IV functional class (according to the NYHA classification), uncontrolled arterial hypertension, renal and hepatic insufficiency.

Drug interactions

With simultaneous use with levodopa preparations, dopamine receptor antagonists, m-anticholinegic the action of the latter can be enhanced.

With simultaneous use with barbiturates and neuroleptics, the effect of the latter may be reduced.

When used together, it can change (increase or decrease) the effect of dantrolene or baclofen, so the doses of drugs should be selected individually.

Concurrent use with amantadine, ketamine, phenytoin and dextromethorphan should be avoided due to the increased risk of developing psychosis.

It is possible to increase the concentration of cimetidine, ranitidine, procainamide, quinidine, quinine and nicotine in the blood plasma when taken together with memantine.

May decrease the level of hydrochlorothiazide when combined with memantine. Memantine is able to increase the excretion of hydrochlorothiazide.

Perhaps an increase in MHO in patients taking oral anticoagulants (warfarin).

Simultaneous use with antidepressants, selective serotonin reuptake inhibitors and MAO inhibitors requires careful monitoring of patients.

In vitro, memantine does not inhibit isoenzymes CYP1A2, 2A6, 2C9, 2D6, 2E1, 3A, flavin-containing monoxidase, epoxyhydrolase, or sulfation.

Pregnancy and Lactation

No data are available on the use of memantine in pregnant women. Memantine should be used only when the expected benefit to the mother outweighs the potential risk to the fetus.

There is no evidence of penetration of memantine into breast milk. Taking into account the lipophilic structure of the active substance of the drug, it can be assumed that memantine can penetrate into breast milk, and therefore it is recommended to stop breastfeeding while taking the drug

Special instructions

With caution prescribed to patients with thyrotoxicosis, epilepsy, convulsions (including history); simultaneous use of NMDA receptor antagonists (amantadine, ketamine, dextromethorphan). the presence of factors that increase the urine pH (abrupt diet change, abundant intake of alkaline gastric buffers), severe urinary tract infections, history of myocardial infarction, heart failure III-IV functional class (according to NYHA classification), uncontrolled arterial hypertension, renal and hepatic failure.

Impact on ability to drive vehicles and other mechanisms

Memantine can cause a change in the reaction rate, so it is necessary to refrain from potentially dangerous activities that require increased concentration of attention and speed of psychomotor reactions.

Overdosage

Symptoms: dizziness, tremor, agitation, drowsiness, confusion, agitation, stupor, convulsions, psychosis, aggressiveness, hallucinations, vomiting, unsteadiness of gait, diarrhea.

Treatment: gastric lavage, taking activated charcoal, symptomatic therapy. There is no specific antidote.

  • Brand name: MEMANTAL
  • Active ingredient: Memantine
  • Dosage form: Film Coated pills
  • Manufacturer: Sinton Spain S.L.

Studies and clinical trials of Memantine (Click to expand)

  1. Memantine in severe dementia: results of the 9M-best study (benefit and efficacy in severly demented patients during treatment with memantine)
  2. Synergistic neurotoxicity by human immunodeficiency virus proteins Tat and gp120: Protection by memantine
  3. The use of NMDA antagonist memantine in drug-resistant dyskinesias resulting from l-dopa
  4. Drug Discovery Research || Mechanism-Based Development of Memantine as a Therapeutic Agent in Treating Alzheimer's Disease and Other Neurologic Disorders: Low-Affinity, Uncompetitive Antagonism with Fast Off-Rate
  5. Congenital nystagmus: Randomized, controlled, double-masked trial of memantine/gabapentin
  6. Memantine and constraint-induced aphasia therapy in chronic poststroke aphasia
  7. Crossover trial of gabapentin and memantine as treatment for acquired nystagmus
  8. Delayed administration of memantine prevents N-methyl-D-aspartate receptor-mediated neurotoxicity
  9. Determination of memantine in rat plasma by HPLC-fluorescence method and its application to study of the pharmacokinetic interaction between memantine and methazolamide
  10. Memantine does not influence AChE inhibition in rat brain by donepezil or rivastigmine but does with DFP and metrifonate in in vivo studies
  11. Novel effects of memantine in antagonizing acute aldicarb toxicity: Mechanistic and applied considerations
  12. Subacute toxicity of aldicarb: Prevention and treatment with memantine and atropine
  13. Protection and reversal by memantine and atropine of carbofuran-induced changes in biomarkers
  14. Memantine in the treatment of binge eating disorder: An open-label, prospective trial
  15. Simultaneous determination of memantine and amantadine in human plasma as fluorescein derivatives by micellar electrokinetic chromatography with laser-induced fluorescence detection and its clinical application
  16. The Alzheimer's disease drug memantine increases the number of radial glia-like progenitor cells in adult hippocampus
  17. Review of donepezil, rivastigmine, galantamine and memantine for the treatment of dementia in Alzheimer's disease in adults with Down syndrome: implications for the intellectual disability population
  18. Memantine enhances autonomy in moderate to severe Alzheimer's disease
  19. The place of memantine in the treatment of Alzheimer's disease: a number needed to treat analysis
  20. Effects of memantine on behavioural symptoms in Alzheimer's disease patients: an analysis of the Neuropsychiatric Inventory (NPI) data of two randomised, controlled studies
  21. A double-blind, placebo-controlled trial of memantine in age-associated memory impairment (memantine in AAMI)
  22. Safety and tolerability of once-daily versus twice-daily memantine: a randomised, double-blind study in moderate to severe Alzheimer's disease
  23. Improvement in behavioural symptoms in patients with moderate to severe Alzheimer's disease by memantine: a pooled data analysis
  24. A 6-month, open-label study of memantine in patients with frontotemporal dementia

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