II. Background

  1. Replaced by newer agents (e.g. Aricept) - avoid use due to hepatotoxicity risk

III. Indications

  1. No longer used in U.S. due to hepatotoxicity risk
  2. Mild to Moderate Dementia (Folstein MMSE: 10-26)

IV. Mechanism

  1. First Acetylcholinesterase Inhibitor
  2. Other agents are now preferred

V. Efficacy

  1. Response in 20% of patients
  2. Aricept offers similar efficacy and less toxicity

VI. Dosing

  1. Start at 10 mg PO qid for 4 weeks
  2. Increase to 20 mg PO qid for 4 weeks
  3. Titrate to maximum of 40 mg

VII. Adverse effects

  1. Hepatotoxicity
    1. Follow Liver Function Tests (esp. SGPT) every 2 weeks

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Tacrine (C0039245)

Definition (MSH) A cholinesterase inhibitor that crosses the blood-brain barrier. Tacrine has been used to counter the effects of muscle relaxants, as a respiratory stimulant, and in the treatment of Alzheimer's disease and other central nervous system disorders.
Definition (CSP) cholinesterase inhibitor that crosses the blood-brain barrier; has been used to counter the effects of muscle relaxants, as a respiratory stimulant, and to improve cognitive performance in the treatment of Alzheimer's disease and other central nervous system disorders.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D013619
SnomedCT 108494008, 373727000
LNC LP17860-5, MTHU024717
English 1,2,3,4-Tetrahydroaminoacridine, 9-Amino-1,2,3,4-Tetrahydroacridine, Tetrahydroaminoacridine, 1,2,3,4-Tetrahydro-9-acridinamine, tetrahydroaminoacridine, 9-Acridinamine, 1,2,3,4-tetrahydro-, TACRINE, THA, tacrine (medication), tacrine, Tacrine [Chemical/Ingredient], tha, Tacrine (product), Tacrine (substance), Tacrine
Swedish Takrin
Czech takrin
Finnish Takriini
Russian TETRAGIDROAMINOAKRIDIN, TAKRIN, ТАКРИН, ТЕТРАГИДРОАМИНОАКРИДИН
Japanese テトラハイドロアミノアクリジン, タクリン, テトラヒドロアミノアクリジン
Polish Takryna
Portuguese Tetra-Hidroaminoacridina, Tetraidroaminoacridina, Tacrina
Spanish tacrina (producto), tacrina (sustancia), tacrina, Tacrina, Tetrahidroaminoacridina
French Tacrine
German Tacrin, Tetrahydroaminoacridin
Italian Tacrina

Ontology: Cognex (C0699954)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D013619
English cognex, Cognex, Horizon Brand of Tacrine Hydrochloride, OTL Pharm Brand of Tacrine Hydrochloride, Parke Davis Brand of Tacrine Hydrochloride