MEMANTINE (Systemic)

Some commonly used brand names are:

In the U.S.?

• Namenda

In Canada?

• Ebixa

Category

• Dementia symptoms treatment adjunct

Description

Memantine (me-MAN-teen) is used to treatmoderate to severe Alzheimer's disease. Memantine is not a cure for Alzheimer'sdisease but it can help people with the disease. Memantine will not cure Alzheimer'sdisease, and it will not stop the disease from getting worse.

This medicine is available only with your doctor's prescription, in thefollowing dosage forms:

Oral
• Solution (U.S.)
• Tablets (U.S.)

Before Using This Medicine

In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For memantine, the followingshould be considered:

Allergies?Tell your doctor if you have ever had any unusualor allergic reaction to memantine. Also tell your doctor and pharmacist ifyou are allergic to any other substances, such as foods, preservatives, ordyes.

Pregnancy?Memantine has not been studied in pregnant women.However, memantine has not been shown to cause birth defects or other problemsin animal studies.

Breast-feeding?It is not known whether memantine passes intobreast milk. Although most medicines pass into breast milk in small amounts,many of them may be used safely when breast feeding. Mothers who are takingthis medicine and who wish to breast feed should discuss it with their doctor.

Children?Studies on this medicine have only been done inadult patients, and there is no specific information comparing the use ofmemantine in children with use in other age groups. This medicine is generallynot used in children.

Older adults?This medicine has been studied in older adults and has not beenshown to cause different side effects or problems in older people than itdoes in younger adults.

Other medical problems?The presence of other medical problems mayaffect the use of memantine. Make sure you tell your doctor if you have anyother medical problems, especially:

• Kidney disease?Memantine may make this condition worse. Patientswith severe kidney disease may need to take a smaller amount of memantine.

• Difficult urination
• Urinary tract problems
• Urinary tract blockage?Memantine may make these conditionsworse.

• Epilepsy or history of seizures?Memantine may make this medicalcondition worse.

Proper Use of This Medicine

Dosing?For patients taking the oral solutionform of this medicine:

• Remove oral dosing syringe along with the cap and plastic tube fromthe bag and attach to tube to the cap.
• Open the child-resistant cap on the bottle by pushing down on thecap while turning the cap counter-clockwise (to the left) and remove the capand seal from the bottle.
• Insert the plastic tube fully into the bottle and screw the cap tightlyonto the bottle by turning the cap clockwise (to the right).
• Keeping the bottle upright on the table, remove the lid to uncoverthe opening on the top of the cap. With the plunger fully depressed, insertthe tip of the syringe firmly into the opening of the cap.
• While holding the syringe, gently pull the plunger of the syringeup to draw medicine into the syringe.
• Remove the syringe from the cap opening. Invert the syringe (pointtip upwards) and slowly press the plunger to a level that pushed out any largeair bubbles that may be present. Keep the plunger in this position.
• Re-insert the tip of the syringe into the cap opening. While holdingthe syringe, continue to gently pull out the plunger until the bottom of theblack ring of the plunger reaches the appropriate mark on the syringe thatcorresponds to the dose prescribed.
• Remove the syringe from the bottle and swallow the oral solutiondirectly 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 syringeinto a glass of water, pulling the plunger out to draw in water, and pushingthe plunger in to remove the water. Repeat several times. Allow the syringeto air dry.

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 yourdoctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine.Also, the number of doses you take each day and the timeallowed between doses will be determined by your doctor.

• For oral dosage form (oral solution andtablets)
  • For treatment of Alzheimer's disease
    • Adults?To start, take 5 mg (milligrams) once a day. Your doctormay increase your dose gradually up to 10 mg (milligrams) twice a day.
    • Children?This medicine is not used in children.

Missed dose?If you miss a dose of this medicine, take itas soon as possible. However, if it is almost time for your next dose, skipthe missed dose and go back to your regular dosing schedule. Do not doubledoses.

Storage?To store this medicine:

• Keep out of the reach of children.
• Do not store in the bathroom, near the kitchen sink, or in otherdamp places. Heat or moisture may cause the medicine to break down.
• Keep the medicine from freezing. Do not refrigerate.
• Do not keep outdated medicine or medicine no longer needed. Ask yourhealth care professional how you should dispose of any medicine you do notuse. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

It is very important that your healthcare professional check your progressat regular visits to make sure that this medicine is working properlyand to check for unwanted effects.

Side Effects of This Medicine

Along with its needed effects, a medicinemay cause some unwanted effects. Although not all of these side effects mayoccur, if they do occur they may need medical attention.

Check with your doctorimmediately if any of the following side effects occur:

Less common

Bloating or swelling of face, arms, hands, lower legs, or feet; blurred vision; dizziness; headache; nervousness; pounding in the ears; rapid weight gain; slow or fast heartbeat; tingling of hands or feet; unusual weightgain or loss

Incidence not known

Abdominal pain; agitation; black, tarry stools; bleeding gums; blistering, peeling, loosening of skin; bloating; blood in urine or stools; chest pain; coma; constipation; continuing vomiting; convulsions; dark-colored urine; decreased urine output; depression; fainting; fast, pounding, or irregularheartbeat or pulse; general feeling of tirednessor weakness; high fever; high or low blood pressure; hostility; increased sweating; indigestion; infection from breathing foreign substances into the lungs; itching; lethargy; light-colored stools; lip smacking or puckering; loss of consciousness; muscle twitching; no blood pressure; nobreathing; no pulse; numbnessor tingling in face, arms, legs; pain or swellingin arms or legs without any injury; pain, tension,and weakness upon walking that subsides during periods of rest; pains in stomach, side, or abdomen, possibly radiating to theback; palpitations; pinpointred spots on skin; pounding, slow heartbeat; puffing of cheeks; rapid or worm-likemovements of tongue; rapid weight gain; recurrent fainting; red irritated eyes; red skin lesions, often with a purple center; seizures; severe constipation; severe headache; severe muscle stiffness; severe vomiting; sores,ulcers, or white spots in mouth or on lips; stomachpain; stupor; sudden severeweakness; swelling of face, ankles, or hands; total body jerking; trouble speakingor walking; troubled breathing; twitching, twisting, uncontrolled repetitive movements of tongue, lips, face,arms, or legs; uncontrolled chewing movements; uncontrolled movements of arms and legs; unusual bleeding or bruising; unusually pale skin; vomiting; yellow eyesand skin

Other side effects may occur that usually do not need medicalattention. These side effects may go away during treatment as your body adjuststo the medicine. However, check with your doctor if any of the following sideeffects continue or are bothersome.

More common

Confusion

Less common

Anxiety; back pain; bladder pain; bloody or cloudy urine; change in walking and balance; chills; clumsiness or unsteadiness; cough producing mucus; coughing; difficult, burning, or painful urination; difficultybreathing; difficulty moving; difficulty having a bowel movement (stool); diarrhea; discouragement; dry mouth; fear; feeling sad or empty; fever; frequent urge tourinate; general feeling of discomfort or illness; hyperventilation; insomnia; irregular heartbeats; irritability; joint pain; loss of appetite; loss of bladder control; loss of interest or pleasure; lowerback or side pain; muscle pain or stiffness; nausea; nervousness; pain; pain in joints; restlessness; seeing, hearing, or feeling things that are notthere; shortness of breath; sleepiness or unusual drowsiness; sore throat; tightness in chest; tiredness; trouble concentrating; trouble sleeping; unusual tiredness or weakness; vomiting; wheezing

Incidence not known

Burning feeling in chest or stomach; burning, numbness, pain, or tingling in all fingers except smallest finger; cold sweats; cool paleskin; decreased interest in sexual intercourse; difficulty swallowing; general feelingof discomfort or illness; heartburn; inability to have or keep an erection; increased hunger; large amount of fat in the blood; loss in sexual ability, desire, drive, or performance; nightmares; shakiness; slurred speech; stomachcramps; stomach upset; tenderness in stomach area; watery or bloody diarrhea

Otherside effects not listed above may also occur in some patients. If you noticeany other effects, check with your doctor.