Namenda

There are basically two classes of drugs which are used for treating the symptoms caused due to Alzheimer’s disease. The first being the cholinesterase inhibitors and the second one is NMDA antagonists. Namenda is one of the NMDA antagonists that contains the active ingredient called Memantine.

Unlike cholinesterase inhibitors that work by boosting the levels of acetylcholine, memantine works on another chemical system present in the brain which is said to involve glutamate called neurotransmitters.

Namenda is used in the treatment of moderate to severe Alzheimer type of dementia. It works by preventing activity of glutamate in the brain. It does not cure the Alzheimer disease, but helps to reduce the symptoms of Alzheimer’s by reducing the actions of the chemicals present in the brain that contribute to the various symptoms leading to Alzheimer’s disease.

It is available in capsule (extended release form), tablet and solution form and only with your doctor’s prescription. Namenda can also be used for any other purposes which are not listed above.

Before using Namenda, you must know all about the risks and complications associated with it.

Allergy

Inform your doctor if you are allergic to any food, preservatives, dyes, or had an allergic reaction when you used this drug before.

Children

There are no adequate studies done which prove Memantine’s harmful effects in children. It is not expected to cause different effects than adults. However, safety and efficacy have not been established.

Elderly

This medicine does not cause any different side effects or problem than it does in younger adults. However, it should be used with caution.

Pregnancy

It is a category B drug. It is safe to use in pregnancy.

Breast Feeding

Memantine is not known if it can pass into breast milk or not. If you are using it while nursing, discuss the potential risks with your doctor.

Drug Interactions

• Memantine may interact with other drugs. Your doctor should be informed of any other medicines which you are taking. He may want to change the dosage or drug. Some of them are listed below:
• Amantadine
• Carbonic anhydrase inhibitors (acetazolamide)
• Cimetidine (Tagamet)
• Certain cold or cough medicines which also contain Dextromethorphan
• Ketamine
• Sodium bicarbonate
• Brinzolamide
• Certain medicines which are used for the treatment of glaucoma like acetazolamide (Diamox), Methazolamide (Neptazane or MZM)
• Oral medications of diabetes which is known to contain metformin such as Metaglip, Actoplus Met, Fortamet, Glucovance, Avanda met or Glucophage
• Bupropion
• Nicotine such as Nicoderm, Commit, or Nicorette
• Diuretic or water pills such as triamterene which include Dyazide, Maxzide or Dyrenium. Hydrochlorothiazides such as HCTZ, Lopressor, Zestoretic or hydrodiuril.
• Ranitidine such as Zantac
• Quinidine such as quinadex, Cardoioquin or Quinaglute
• Sodium bicarbonate, also known as baking soda which is used at every home and alka-seltzer
• Antiviral medications such as rimantadine

This may not be the complete list of medications which can interact with Namenda, hence it is important to inform the doctor if you are taking any medications whether over-the-counter or prescribed, any vitamins, dietary supplements or herbal supplements. Also, it is important to not start or stop any of the medications without prior consultation from the doctor.

Other Medical Conditions

Several other conditions may reduce its effectiveness.

Make sure you inform your doctor of conditions such as:

• Liver problems
• History of bladder disease
• Kidney problems
• Seizures
• Trouble urinating
• Urinary tract infection

Make sure you inform your doctor of conditions such as:

• Liver problems
• History of bladder disease
• Kidney problems
• Seizures
• Trouble urinating
• Urinary tract infection

Proper usage of Namenda requires strict adherence to your doctor’s orders. Read the medication guide carefully. Ask your pharmacist if you have any queries.

Take this medicine by mouth with a full glass of water with or without food. Swallow it as a whole, do not crush, chew or break it.

If you have difficulty in swallowing its extended release form in a capsule, you can open and pour it in a small amount of soft food (applesauce), mix it and swallow it without chewing. Do not save this mixture for later use, it has to be consumed as soon as it is broken and mixed.

It is important to follow all the guidelines mentioned by the doctor on the dosage as well as the intake of this medicine. You can also refer to the directions which are mentioned on the prescription label. The doctor can look to occasionally change the dose of this medicine to ensure that the individual gets best results of the treatment. Avoid taking larger or smaller than recommended doses of this medicine without approval from the doctor.

Namenda can be taken either with or without food. When it comes to the liquid solution of this medicine, it should be measured properly with the help of a dosing syringe which is mostly provided along with the medicine or you can also use a special dose measuring spoon for the same. Ensure not to mix the oral form of this medicine with any other kind of liquids. After every use of the medicine, ensure to empty the oral syringe with clean and sterile water and later allow it to dry properly. 

To gain the maximum benefit from the treatment, it is important to use Namenda on a regular basis and mostly at the same time. In case you run out of the medicine, then get it refilled beforehand itself. The doctor would keep a tab and check the performance of the medicine on the body on a timely basis.

Namenda should be stored at room temperature and away from light, heat and moisture. Ensure that the medicine is stored in a tight bottle secured with the provided cap. One should not store the bottle along with the oral syringe in it.

Dosage

It is different for different patients. Dosage mentioned below is an average dose. You must follow your doctor’s instructions.

Extended release capsules form

Adults: 7 milligrams (mg) per day and this can then be increased on a weekly basis by 7mg. The dose is usually not more than 28 mg per day.

Solution and tablets forms 

Adults: 5 mg per day. The dose is usually not more than 10 mg. The maximum dose should not be more than 20mg per day.

The dose of children is determined by your doctor in both types of medicine.

Missed Dose

If you miss a dose, take it as soon as you remember it. If it almost time for your next dose, skip the missed dose and continue your daily schedule. Doubling the dose is harmful.

Storage

Store it at room temperature. Keep it away from children.

Before using Namenda, there are some precautions you must take. Your doctor should check your daily progress at regular visits. He may want a blood or urine test to check for unwanted effects.

Tell your doctor or dentist that you take Memantine before you receive any medical or dental care, emergency care, or surgery. Do not take any other medicine unless it is discussed with your doctor.

Memantine may cause:

• drowsiness,
• dizziness,
• blurred vision,
• light-headedness.

These effects may be worse if you take it with alcohol or certain medicines. Use Memantine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

As with many medications, there are several potential side effects associated with Namenda. Some people may experience none or minor side effects.

Consult with your doctor if they become problematic or frequent:

More common are:

• Constipation
• Dizziness
• Headache

Less common are:

• Bloating or swelling of the face, arms, hands, lower legs, or feet.
• Blurred vision
• Dizziness
• Headache
• Nervousness
• Pounding in the ears
• Rapid weight gain
• Slow or fast heartbeat
• Tingling of the hands or feet.
• Unusual weight gain or loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Overdose
It is important to reach out to the doctor in case the individual has overdosed on Namenda.
Few of the overdose symptoms would include:
• Drowsiness
• feeling very light headed
• unusual behavior of the individual
• getting very restless
• fainting
• getting agitated very quickly
• feelings of confusion
• unconsciousness
• delusions or psychosis
• vertigo which is a feeling of a spinning sensation
• vomiting,
• changes in the rhythm of the heart
• hallucinations

If it gets very serious, then it can lead to coma. Hence, it is important to gain medical attention when the individual has taken extra medicine which can eventually turn out to be an overdose case. If the overdose happened recently, then the doctor would pump the stomach or would give certain medications to the individual so that it induces vomiting and the medicine can come out. Also, the doctor would provide certain medications which would make the urine more acidic, thereby helping the body in removing Namenda more quickly.

The treatment would mostly involve supportive care which is known to help treat the overdose symptoms that have occurred by taking extra medicine. A supportive treatment option for overdose of Namenda can include any of the below:

• The doctor would carry out careful monitoring of the blood pressure, heart, as well as breathing.
• There can be fluids given to the patient through IV or intravenous line.
• Based on the complication which has occurred, the doctor can then decide on what other treatment options can be carried out.

Namenda and Migraine

Currently, research on this topic is still at an early stage. One of the examples would be that a woman who has reported describing about how she was suffering from chronic cases of migraines and they had stopped unexpectedly when she was prescribed to start taking Namenda for this mild cognitive impairment.

Also, there was a small study or survey carried out which showed that out of 54 people, 36 of them were being prescribed Namenda for preventing migraine attacks and they seemed to report that there was significant reduction in the frequency of the migraine headaches. It is very important to understand that this study only merely suggested that this drug may be useful with migraines as well, but it cannot be described as that type of study which would clearly demonstrate that Namenda would really work well for migraines as well. Currently, there are no fool proof evidences to suggest the same and whether this medicine has any significant role in reducing migraine headaches. It is too early to say if the drug really works as well as it should, but it may be an option to be considered only if the other treatments have shown no results or failed to provide relief.