Pharm

Galantamine

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Galantamine, Reminyl, Razadyne

  • Indication
  • Mechanism
  1. Acetylcholinesterase Inhibitor
  2. Acts also at nicotinic receptors
  3. Derived from Daffodil bulbs
  • Pharmacokinetics
  1. Half-Life: 7 hours in elderly patients
  2. Metabolized by liver enzymes: CYP2D6 and CYP3A4
  • Dosing
  1. May require concurrent Antiemetic use
  2. Immediate Release
    1. Start: 4 mg orally twice daily with breakfast and dinner for 4 weeks
    2. Maintenance: 8 mg orally twice daily for at least 4 weeks
    3. Consider increase to 12 mg orally twice daily if indicated
  3. Extended Release
    1. Start: 8 mg orally daily for 4 weeks
    2. Maintenance: 16 mg orally daily for at least 4 weeks
    3. Consider increase to 24 mg orally daily if indicated
  • Adverse Effects
  1. See Acetylcholinesterase Inhibitor
  2. Bradycardia has also been reported with Galantamine
  • Efficacy
  1. Moderately preserved cognitive function for >6 months
  2. References
    1. Raskind (2000) Neurology 54:2261 [PubMed]
    2. Tariot (2000) Neurology 54:2269 [PubMed]