Uses

The combination of donepezil and memantine is indicated for the treatment of moderate to severe dementia of the Alzheimer's type in patients already stabilised on donepezil 10 mg once daily. It combines an acetylcholinesterase inhibitor with an NMDA receptor antagonist for a complementary approach to managing Alzheimer's disease.

Do not use if

Contraindicated in patients with known hypersensitivity to memantine, donepezil, piperidine derivatives, or any excipients in the formulation.

Side effects

Common adverse effects include nausea, vomiting, diarrhoea, dizziness, headache, and insomnia. Serious reactions may include cardiac arrhythmias with vagotonic effects, peptic ulcer disease, gastrointestinal bleeding, and urinary retention.

Warnings

May exaggerate succinylcholine-type muscle relaxation during anaesthesia. Vagotonic effects may cause bradycardia or syncope. Patients should be monitored for signs of active gastrointestinal bleeding, urinary retention, and seizures. Use with caution in patients with severe renal impairment.

How it works

Donepezil reversibly inhibits acetylcholinesterase, increasing synaptic acetylcholine levels to enhance cholinergic neurotransmission. Memantine is a non-competitive NMDA receptor antagonist that reduces pathological glutamate excitotoxicity without interfering with normal synaptic glutamate signalling, providing neuroprotective effects in Alzheimer's disease.

Storage

Store at controlled room temperature, typically 15°C to 30°C (59°F to 86°F), in the original packaging.