memantine hydrochloride 20 mg. Auxiliary substances: microcrystalline cellulose - 263.5 mg, croscarmellose sodium - 13.5 mg, colloidal silicon dioxide - 1.5 mg, magnesium stearate - 1.5 mg. The composition of the shell: opadra pink - 12 mg (hypromellose - 7.5 mg, titanium dioxide (E171) - 3.3984 mg, macrogol 400 - 0.75 mg, iron red oxide (E172) - 0.2004 mg, iron yellow oxide (E171) - 0.1512 mg)
Pharmacological action - a remedy for the treatment of dementia. Akatinol - a drug to improve brain metabolism, which has a nootropic and neuroprotective effect.
Being a non-competitive antagonist of N-methyl-D-aspartate (NMDA) receptors, it has a modulating effect on the glutamatergic system. It regulates ion transport, blocks calcium channels, normalizes membrane potential, improves the transmission of nerve impulses. Improves cognitive processes, increases daily activity. After ingestion is quickly and completely absorbed. Cmax in plasma is achieved within 2–6 hours. In normal renal function, cumulation of the drug is not observed. Withdrawal proceeds in two phases. T1 / 2 is in the first phase - 4–9 hours, in the second - 40–65 hours. Excreted in the urine.
Dementia of Alzheimer's type, vascular dementia, mixed dementia of all degrees of severity.
Individual hypersensitivity to the drug. Pregnancy. Breast-feeding. Severe renal failure (creatinine clearance 5 - 29 ml / min). Severe liver failure. Children under 18 years (due to lack of data). Caution should be prescribed: Thyrotoxicosis. Epilepsy. Convulsions (including history). The simultaneous use of antagonists NMDA - receptors: Amantadine. Ketamine. Dextromethorphan. Factors that increase the pH of urine: A sharp change of diet (the transition to vegetarianism). Abundant intake of alkaline gastric buffers. Severe urinary tract infections. Myocardial infarction (in history). Chronic heart failure III - IV functional class (according to the NYHA classification). Uncontrolled arterial hypertension. Liver failure.
With caution prescribed for epilepsy, patients with thyrotoxicosis.The optimal dose is achieved gradually, with a weekly increase.
Use during pregnancy and lactation
Contraindicated in pregnancy. At the time of treatment should stop breastfeeding.
Dosage and administration
Inside, while eating. The dosage regimen is set individually. It is recommended to begin treatment with the appointment of the minimum effective doses. Adults with dementia during the 1st week of therapy - at a dose of 5 mg / day, 2nd week - at a dose of 10 mg / day, 3rd week - at a dose of 15–20 mg / day. If necessary, a further weekly dose increase of 10 mg is possible until a daily dose of 30 mg is reached. The optimal dose is achieved gradually, with an increase in dose every week.
Adverse reactions are classified according to clinical manifestations (according to the lesion of certain organ systems) and according to the frequency of occurrence: very often - ≥1 / 10; often - ≥1 / 100– <1/10; infrequently - ≥1 / 1000 – ≤1 / 100); rarely, ≥1 / 10000– <1/1000; very rarely - ≤1 / 10,000; Frequency is not established - currently there are no data on the prevalence of adverse reactions. Hallucinations have been observed mainly in patients with Alzheimer's disease at the stage of severe dementia. There are separate reports of the occurrence of these adverse reactions in the use of the drug in clinical practice (data obtained after the appearance of the drug on the market).
Symptoms: increased severity of side effects. Treatment: gastric lavage, taking activated charcoal, symptomatic therapy.
Interaction with other drugs
With simultaneous use with drugs L-dopa, dopamine agonists, anticholinergic agents, the action of the latter can be enhanced. With simultaneous use with barbiturates, neuroleptics, the effect of the latter may be reduced. When used together, it can change (increase or decrease) the effect of dantrolene or baclofen, so the doses of drugs should be selected individually. Concurrent administration with amantadine, ketamine and dexamethorphan should be avoided. There may be an increase in plasma levels of cimetidine, procainamide, quinidine, kinin and nicotine while taking it with memantine. May decrease the level of hydrochlorothiazide while taking with memantine.
In patients with Alzheimer's disease at the stage of moderate and severe dementia, the ability to drive vehicles and manage complex mechanisms is usually impaired. In addition, memantine may cause a change in the reaction rate, therefore, patients receiving outpatient treatment should take special care when driving or operating machinery.