Alzmenda 20 mg ( Memantine ) 28 film-coated tablets

Brand Name:  Alzmenda 5mg Tablet
                       Alzmenda 10mg Tablet
                       Alzmenda 20mg Tablet

Active Ingredient: Memantine HCL

When is Alzmenda Tablet prescribed for?
Alzmenda Tablets prescribed for the Treatment of the symptoms of moderate to severe Alzheimer's disease

How should you take Alzmenda Tablets?

Adults: The recommended dose is 10 mg twice daily. 

This is achieved by upward titration as follows:

• Treatment should be started with 5 mg daily during the 1st week.
• In the 2nd week the dose is 5 mg twice daily.
• In the 3rd week 15mg/day separate doses is recommended.
• From the 4th week on, treatment is usually continued with the maintenance dose of 10 mg twice daily (20mg once daily).

When you should not take Alzmenda Tablets?
• Severe Renal impairment (patients with a creatinine clearance ≤ 50 mL/min).
• Hypersensitivity to either the active ingredient or any of the excipients.
• Patients with a current seizure disorder or with any history of seizures or in patients with liver disease.
• In patients taking other NMDA antagonists (amantadine [Symmetrel], ketamine [Ketalar], and dextromethorphan [a common component of cough suppressants, such as Robitussin DM]) should be approached with caution.
• Pregnancy and lactation.

Possible Drug interaction with Alzmenda Tablets:

• N-methyl-D-aspartate (NMDA) antagonists:

The combined use of ALZEMENDA with other NMDA antagonists (amantadine, ketamine, and dextromethorphan) has not been systematically evaluated and such use should be approached with caution.

• Acetylcholinesterase (AChE) inhibitors: Coadministration of ALZEMENDA with the AChE inhibitor donepezil HCl did not affect the pharmacokinetics of either compound.the adverse event profile observed with a combination of memantine and donepezil was similar to that of donepezil alone.
• Drugs eliminated via renal mechanisms: Because memantine is eliminated in part by tubular secretion, coadministration of drugs that use the same renal cationic system, including hydrochlorothiazide (HCTZ), triamterene (TA), metformin, cimetidine, ranitidine, quinidine, and nicotine, could potentially result in altered plasma levels of both agents. However, coadministration of ALZMENDA and HCTZ/TA did not affect the bioavailability of either memantine or TA, and the bioavailability of HCTZ decreased by 20%. In addition, coadministration of ALZMENDA with the antihyperglycemic (glyburide and metformin HCl) did not affect the pharmacokinetics of memantine, metformin and glyburide. Furthermore, ALZMENDA did not modify the serum glucose lowering effect of (glyburide and metformin HCl).
• Drugs that make the urine alkaline: The clearance of ALZMENDA was reduced by about 80% under alkaline urine conditions at pH 8. Therefore, this may lead to an accumulation of the drug with a possible increase in adverse effects. Urine pH is altered by diet, drugs (e.g. carbonic anhydrase inhibitors, sodium bicarbonate). Hence, ALZMENDA should be used with caution under these conditions.

Possible Side effects of Alzmenda Tablets

• Confusion
• Dizziness
• Shortness of breath
• Skin rash 
• Vomiting

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