galantamine (Rx)

Brand and Other Names:Razadyne
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablets

  • 4mg
  • 8mg
  • 12mg

tablets, extended-release

  • 8mg
  • 16mg
  • 24mg

oral solution

  • 4mg/mL
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Alzheimer Disease

Initial

  • Conventional: 4 mg PO q12hr
  • ER: 8 mg PO qAM

Maintenance

  • Conventional: Titrate to 8-12 mg PO q12hr; increase by 4 mg q12hr at no less than 4 week intervals
  • ER: 16-24 mg PO qAM; increase by 8 mg/d at no less than 4 week intervals

Hepatic Impairment

Moderate: (Child-Pugh score 7-9): Not to exceed 16 mg/day

Severe: Not recommended

Renal Impairment

Moderate: Not to exceed 16 mg/day

Severe (CrCl <9 mL/min): Not recommended

Administration

Take with food

Conversion from galantamine tablets and oral solution to galantamine ER should occur at same daily dosage with the last dose of galantamine tablets/oral solution taken in evening and starting galantamine ER once daily treatment next morning

Not recommended

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Interactions

Interaction Checker

and galantamine

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Nausea (20-25%)

            Diarrhea (11-15%)

            Vomiting (11-15%)

            1-10%

            Abdominal pain

            Anorexia

            Muscle cramp

            Fatigue

            Dizziness

            Headache

            Weight loss

            Depression

            Insomnia

            UTI

            Somnolence

            Anemia

            Syncope

            Bradycardia

            Other Information

            Complete atrioventricular block

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            Warnings

            Contraindications

            Hypersensitivity

            Cautions

            Moderate hepatic or renal impairment: max 8 mg q12hr (conventional) or 16 mg qDay (ER)

            Not recommended in severe hepatic or renal impairment

            Renamed Razadyne from Reminyl in the US to avoid confusion with Amaryl

            Serious skin reactions may occur; discontinue at first appearance of skin rash

            All patients should be considered at risk for adverse effects on cardiac conduction, including bradycardia and AV block, due to vagotonic effects on sinoatrial and atrioventricular nodes

            Active or occult gastrointestinal bleeding: monitor, especially those with an increased risk for developing ulcers

            Cholinomimetics may cause bladder outflow obstruction

            Monitor for respiratory adverse events in patients with a history of severe asthma or obstructive pulmonary disease

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: unknown

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Derived from daffodil bulbs

            Increases acetylcholine from surviving presynaptic nerve terminals by modulating the nicotinic acetylcholine receptor. Glutamate and serotonin levels may increase

            Pharmacokinetics

            Half-Life: 7 hr

            Peak Plasma Time: 1 hr

            Bioavailability: 90%

            Protein Bound: 18%

            Vd: 175 L

            Metabolism: CYP2D6 & CYP3A4

            Excretion: Urine

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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