Drug Facts: Razadyne, Reminyl (galantamine)

August 3, 2010

Generic name: galantamine

Comes in 4 mg (white), 8 mg (pink) and 12 mg (brown-orange) tablets. Also available as a liquid for those who cannot swallow tablets.

Why It’s Prescribed
To ease the symptoms of early Alzheimer’s. May improve, maintain, or slow the decline in memory, thinking, and activities of daily living, such as dressing, eating, or handling mail. However, it does not halt disease progression long term.

Who Benefits
People with mild to moderate Alzheimer’s disease. The earlier treatment is started, the more effective it may be. About half of patients who try the drug show slight improvements.

How it Works
Originally derived from daffodil bulbs, this drug slows the breakdown of acetylcholine, a chemical that aids memory by transmitting messages between brain cells. It also acts on nicotine receptors in the brain.

Dosage Guidelines
To start: 4 mg twice a day. Dosage should be increased slowly, with at least four weeks between each increase, to minimize side effects. Average daily dose: 16 to 24 mg, taken as two daily doses in the morning and evening. An extended-release formula is also available: It is taken as a single daily dose. Take with food and plenty of fluids to minimize side effects. The liquid form can be mixed with water, juice or soda. Take with food and plenty of fluids to minimize side effects. The liquid form can be mixed with water, juice or soda.

Onset of Effect
For those who respond, benefits typically appear within several weeks of starting the drug.

Store in a tightly sealed container away from heat, moisture and light. Do not freeze the liquid form.

Missed Dose
Take as soon as possible, or if it’s near the time for your next dose, skip the missed dose and resume your normal schedule. If you miss a dose for several days or longer, talk to your doctor, who may re-start you on a lower dose.

Long-term Use
The drug is taken long term and may move the clock back a few months, but the disease continues to progress. If the drug seems to stop working, your doctor may switch you to another Alzheimer’s drug.

Side Effects
Serious: No serious side effects.
Most common: Nausea, vomiting, diarrhea, loss of appetite, weight loss. Usually occur when starting the drug or when dosage is increased. In most people, side effects dissipate with time.
Less common: Fatigue, feeling lightheaded or dizzy, tremor, headaches, abdominal cramps, heartburn, depression, insomnia, drowsiness, runny nose, urinary tract infection or blood in the urine.

Precautions & Special Concerns
Be sure to drink enough fluids while taking this medication. People with serious liver or serious kidney disease should not take this drug. Those with mild liver or kidney problems should limit dose to 16 mg a day. Do not drive until you see how the medicine affects you, since it may cause drowsiness.

When to Call the Doctor
If you experience side effects or the drug seems to stop working.

In Case of Overdose: Symptoms & What to Do
Severe nausea and vomiting, increased salivation, sweating, slowed heartbeat, low blood pressure, irregular breathing, unconsciousness, muscle weakness. Call your doctor, emergency medical services, or poison control center immediately.

Drug Interactions
May interact with paroxetine (Paxil), an antidepressant, and some drugs for Parkinson’s disease. Antihistamines, antipsychotic drugs, and some drugs for incontinence may also diminish its effects.

Food Interactions
No known food interactions. Avoid alcohol while using this medicine.

Disease Interactions
Do not take if you have severe kidney or liver disease. Consult your doctor if you have asthma, lung disease, epilepsy or seizures, heart problems, an ulcer, or urinary tract problems.

Expert comment
“For some people with Alzheimer’s disease, this drug can lead to improvements that the family can see. In others, responses may only be detectable under special testing conditions, or there may be no measurable response at all. It is important that family members and physicians maintain realistic expectations for drug therapy and remember that, as with all current Alzheimer’s drugs, responses are generally only modest at best.” –Samuel E. Gandy, M.D., Ph.D., Scientific Advisory Board, Fisher Center for Alzheimer’s Research Foundation


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