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Canada Drugs:Namenda For Alzheimer's Disease

Namenda , containing the active ingredient memantine hydrochloride, is a novel drug used for the treatment of Alzheimer's disease and dementia-related symptoms. Memantine hydrochloride blocks N-methyl-D-aspartate glutamate receptors, thus controlling various symptoms attributable to Alzheimer's disease. Namenda is a prescription drug.

Indication/Usage: Namenda is approved for the treatment of Alzheimer's disease and moderate to severe dementia of the Alzheimer's type. Namenda is also a good and recommended treatment option for patients who fail on other drugs of this class. As per new guidance, memantine- containing drugs are recommended for patients who are intolerant of or have a contraindication to acetyl cholinesterase (AChE) enzyme inhibitors. Memantine hydrochloride also has a moderate effect in decreasing clinical deterioration, while it improves cognition, mood, and behavior. With the help of Namenda, patients with moderate to severe Alzheimer's disease can function better in their daily lives.

Generic Drug for Namenda: Memantine HCI

Dose, Administration and Dosage Forms: Namenda is available in 5 mg and 10 mg strength tablets; 7 mg, 14 mg, 21 mg and 28 mg strength extended-release capsules; and 2 mg/ml strength oral solution. The recommended starting dose of Namenda is 5 mg once per day which may be titrated up to 20 mg per day. The dose should be titrated gradually in 5 mg increments from 5 mg once per day to 5 mg twice per day; then 15 mg per day in two separate doses of 5 mg and 10 mg each. The final titration would be 20 mg per day in two 10 mg dosages per day. 20 mg per day is the optimum dose which effects the best possible results in most patients. The dose titration should be done at weekly intervals only. Namenda can be administered with or without meals and should be stored at room temperature ranging between 15 C to 30 C.

Mechanism of Action: Namenda contains the active ingredient, memantine hydrochloride, which is an N-methyl-D-aspartate (NMDA) receptor antagonist. A continuous activation of CNS by NMDA receptors has been hypothesized to cause Alzheimer's disease. Memantine hydrochloride helps to control Alzheimer's symptoms by non-competitive NMDA receptor antagonism. It binds preferentially to the cation channels which are operated by NMDA receptor.

Side-effects and Safety Profile: Memantine hydrochloride containing drugs are reported to be well-tolerated; however, there are side-effects involved. Namenda-associated serious side-effects reported in clinical trials include confused mental state, chest tightness and chest pain, agitation, trouble breathing, reversible neurological impairment, hallucinations, disruption of cognitive flexibility, rapid heart rate, fainting, seizure, loss of coordination, hypertonia, abnormal bruising or bleeding, blurred vision, etc.

Namenda is reported to cause the rare side-effect, dystonia, in the young population.

• Namenda is contraindicated in patients with known allergic reactions to memantine.
• Patients must be advised of a possible increase in memantine hydrochloride plasma levels due to decreased urinary elimination caused by raised urine pH.
• Namenda dosage titration is not needed in patients with mild or moderate hepatic or renal impairment. It should be administered with caution in patients with severe hepatic impairment and a dose cutback is recommended in patients with severe renal impairment.
• Namenda is classified as a pregnancy category B drug. Preclinical studies suggest that memantine hydrochloride is not teratogenic; however, it has not yet been studied in well-controlled clinical studies. Therefore, it should be used in pregnant women only if the potential benefit justifies the potential risk to the fetus.
• It is not known whether memantine hydrochloride is excreted in human milk while breastfeeding; therefore, Namenda should be prescribed to nursing women with precaution and close monitoring by a specialist is recommended.

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