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NERVOUS SYSTEM › PSYCHOANALEPTICS › ANTI-DEMENTIA DRUGS › Anticholinesterases
galantamine
N06DA04
Forms & Strengths
- Oral tablets: 4 mg, 8 mg, 12 mg
- Extended-release capsules: 8 mg, 16 mg, 24 mg
- Oral solution: 4 mg/mL
Adult Dosing
- Immediate-release tablets/solution: Initially 4 mg twice daily, increase by 8 mg/day increments at minimum 4-week intervals to maintenance of 8 to 12 mg twice daily
- Extended-release capsules: Initially 8 mg once daily, increase by 8 mg/day increments at minimum 4-week intervals to maintenance of 16 to 24 mg once daily
- Switching from IR to ER: Administer the same total daily dose once daily
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
- Not indicated for use in children
Indications
- Treatment of mild to moderate dementia of the Alzheimer's type
Mechanism of Action
- Reversible, competitive acetylcholinesterase inhibitor
- Allosteric modulation of nicotinic acetylcholine receptors to enhance acetylcholine release
Contraindications
- Known hypersensitivity to galantamine or excipients
- Severe hepatic impairment (Child-Pugh score > 9)
- Severe renal impairment (CrCl < 9 mL/min)
Adverse Reactions
- Nausea, vomiting, diarrhea, anorexia, weight loss
- Dizziness, headache, somnolence, insomnia
- Bradycardia, syncope, AV block
- Muscle cramps, fatigue
Drug Interactions
- CYP3A4 and CYP2D6 inhibitors (e.g., ketoconazole, erythromycin, paroxetine) increase galantamine exposure
- Cholinesterase inhibitors and neuromuscular blocking agents may have additive pharmacodynamic effects
- Beta-blockers, digoxin, and other rate-lowering agents increase risk of severe bradycardia
- Anticholinergic drugs may antagonize the therapeutic effects of acetylcholinesterase inhibitors
Curated Content: Needs Vetting Before Put to Clinical Use