Indications
Galantamine is a prescription medicine used to treat the symptoms of mild to moderately severe dementia of the Alzheimer’s type in adults. It can help with memory, thinking, and the ability to carry out daily activities for a time, but it does not cure the disease or stop it progressing.
How It Works
In Alzheimer’s disease there is a shortage of acetylcholine, a chemical messenger important for memory and learning. Galantamine blocks acetylcholinesterase, the enzyme that breaks acetylcholine down, so more of it remains available in the brain. It also enhances the response of nicotinic receptors to acetylcholine.
Dosage and Administration
Take as prescribed. With standard tablets, treatment is usually started at 4 mg twice a day with the morning and evening meals for four weeks, then increased to 8 mg twice a day; the doctor may increase it further to 12 mg twice a day after at least another four weeks. With once-daily extended-release capsules, the usual start is 8 mg once a day in the morning with food, increased step by step by the doctor. Drink plenty of fluids. If treatment is stopped for more than a few days, do not restart at the old dose without speaking to your doctor.
Interactions
- Paroxetine, Fluoxetine, Ketoconazole, Erythromycin and Ritonavir may raise Galantamine levels and side effects.
- Beta-blockers, Digoxin, Diltiazem and Verapamil may slow the heart further.
- Anticholinergic medicines (such as some bladder, travel sickness or older allergy medicines) work against it.
- NSAIDs such as Ibuprofen may add to the risk of stomach ulcers.
- Muscle relaxants used in anaesthesia (such as Suxamethonium): tell the anaesthetist you take Galantamine.
Contraindications
- Severe liver disease.
- Severe kidney disease.
- Allergy to Galantamine or any ingredient.
Side Effects
Common side effects, mostly at the start or after a dose increase, include nausea, vomiting, loss of appetite, weight loss, diarrhoea, stomach pain, dizziness, headache, tiredness, sleepiness, low mood and slow heartbeat.
Get urgent medical help if you faint, have a very slow or irregular heartbeat, chest pain, black or bloody stools or vomit that looks like coffee grounds, a seizure, difficulty passing urine, or a severe skin rash with blisters or peeling.
Pregnancy and Lactation
It is generally not used in pregnancy unless clearly needed. Breastfeeding is not recommended during treatment.
Precautions and Warnings
- Use with caution in people with heart rhythm problems, asthma or COPD, stomach ulcers, seizures, recent bowel or bladder surgery, or urinary blockage.
- The patient’s weight should be checked regularly.
- Dizziness or sleepiness may affect driving.
- A carer should help make sure doses are taken correctly.
Overdose
Overdose may cause severe nausea and vomiting, sweating, drooling, stomach cramps, muscle weakness or twitching, slow heartbeat, low blood pressure, seizures and breathing difficulty. Seek emergency medical help immediately.
Therapeutic Class
Anti-dementia agent, acetylcholinesterase inhibitor
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.