Dosing & Uses
Dosage Forms & Strengths
memantine/donepezil
capsule ER
- 7mg/10mg
- 14mg/10mg
- 21mg/10mg
- 28mg/10mg
Alzheimer Disease
Fixed dose combination product for patients with moderate-to-severe Alzheimer disease currently stabilized on donepezil 10 mg once daily
Recommended dose is 28 mg/10 mg PO qDay
Stabilized on donepezil and not currently on memantine
- Starting dose is 7 mg/10 mg PO, taken once a day in the evening
- Increase dose in 7 mg increments based on the memantine component to the recommended maintenance dose of 28 mg/10 mg once daily
- The minimum recommended interval between dose increases is 1 week
- Only increase if the previous dose is well tolerated
- Maximum dose: 28 mg/10 mg qDay
Stabilized on both donepezil and memantine
- Patients on memantine (10 mg BID or 28 mg extended-release qDay) and donepezil 10 mg/day can be switched to Namzaric 28 mg/10 mg PO, taken once a day in the evening
- Initiate the day following the last dose of memantine and donepezil administered separately
Dosage Modifications
Severe renal impairment
- Severe renal impairment (CrCl 5-29 mL/min, based on the Cockcroft-Gault equation)
-
Stabilized on donepezil 10 mg/day and not currently on memantine
- Recommended starting dose: 7 mg/10 mg PO taken once daily in the evening
- The dose should be increased to the recommended maintenance dose of 14 mg/10 mg once daily in the evening after a minimum of 1 week
-
Stabilized on both donepezil and memantine
- Patients on memantine (5 mg BID or 14 mg extended-release qDay) and donepezil 10 mg/day can be switched to Namzaric 14 mg/10 mg, taken once a day in the evening
Not indicated
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (2)
- dronedarone
donepezil and dronedarone both increase QTc interval. Contraindicated.
- thioridazine
donepezil and thioridazine both increase QTc interval. Contraindicated.
Serious - Use Alternative (86)
- amiodarone
donepezil and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.
- amisulpride
donepezil and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- amoxapine
donepezil and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.
- anagrelide
donepezil and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.
- arsenic trioxide
donepezil and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
donepezil and artemether both increase QTc interval. Avoid or Use Alternate Drug.
- artemether/lumefantrine
donepezil and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine
donepezil and asenapine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and donepezil both increase QTc interval. Avoid or Use Alternate Drug.
- azithromycin
donepezil and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.
- bedaquiline
donepezil and bedaquiline both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine
donepezil and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and donepezil both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and donepezil both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and donepezil both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and donepezil both increase QTc interval. Avoid or Use Alternate Drug.
- ceritinib
donepezil and ceritinib both increase QTc interval. Avoid or Use Alternate Drug.
- chloroquine
donepezil and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.
- chlorpromazine
donepezil and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.
- citalopram
donepezil and citalopram both increase QTc interval. Avoid or Use Alternate Drug.
- clarithromycin
donepezil and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.
- crizotinib
donepezil and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- dextromethorphan
memantine, dextromethorphan. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- disopyramide
donepezil and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.
- dofetilide
donepezil and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.
- droperidol
donepezil and droperidol both increase QTc interval. Avoid or Use Alternate Drug.
- encorafenib
donepezil and encorafenib both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
donepezil and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- eribulin
donepezil and eribulin both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin base
donepezil and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
donepezil and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin lactobionate
donepezil and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin stearate
donepezil and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole and donepezil both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- flecainide
donepezil and flecainide both increase QTc interval. Avoid or Use Alternate Drug.
- foscarnet
donepezil and foscarnet both increase QTc interval. Avoid or Use Alternate Drug.
- glasdegib
donepezil and glasdegib both increase QTc interval. Avoid or Use Alternate Drug.
- histrelin
donepezil and histrelin both increase QTc interval. Avoid or Use Alternate Drug.
- hydroxychloroquine sulfate
donepezil and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.
- ibutilide
donepezil and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.
- iloperidone
donepezil and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.
- inotuzumab
donepezil and inotuzumab both increase QTc interval. Avoid or Use Alternate Drug.
- isoflurane
donepezil and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- ivosidenib
donepezil and ivosidenib both decrease QTc interval. Avoid or Use Alternate Drug.
- ketamine
memantine, ketamine. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- lefamulin
lefamulin and donepezil both increase QTc interval. Avoid or Use Alternate Drug.
- lenvatinib
donepezil and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.
- lithium
donepezil and lithium both increase QTc interval. Avoid or Use Alternate Drug.
- lofexidine
donepezil and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.
- lopinavir
donepezil and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.
- macimorelin
donepezil and macimorelin both increase QTc interval. Avoid or Use Alternate Drug.
- methadone
donepezil and methadone both increase QTc interval. Avoid or Use Alternate Drug.
- midostaurin
donepezil and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
- mobocertinib
donepezil and mobocertinib both increase QTc interval. Avoid or Use Alternate Drug.
- moxifloxacin
donepezil and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- nilotinib
donepezil and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
- ondansetron
donepezil and ondansetron both increase QTc interval. Avoid or Use Alternate Drug.
- osimertinib
donepezil and osimertinib both increase QTc interval. Avoid or Use Alternate Drug.
- oxaliplatin
donepezil and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- ozanimod
donepezil and ozanimod both increase QTc interval. Avoid or Use Alternate Drug.
- paliperidone
donepezil and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.
- pazopanib
donepezil and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.
- pentamidine
donepezil and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.
- pimavanserin
donepezil and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.
- pimozide
donepezil and pimozide both increase QTc interval. Contraindicated.
- pitolisant
donepezil and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- ponesimod
ponesimod, donepezil. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Consult cardiologist if considering treatment. Coadministration of ponesimod with drugs that decrease HR may have additive effects on decreasing HR and should generally not be initiated in these patients.
donepezil and ponesimod both increase QTc interval. Avoid or Use Alternate Drug. - procainamide
donepezil and procainamide both increase QTc interval. Avoid or Use Alternate Drug.
- propafenone
donepezil and propafenone both increase QTc interval. Avoid or Use Alternate Drug.
- quetiapine
donepezil and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.
- quinidine
donepezil and quinidine both increase QTc interval. Contraindicated.
- quinine
donepezil and quinine both increase QTc interval. Avoid or Use Alternate Drug.
- ribociclib
ribociclib will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
donepezil and ribociclib both increase QTc interval. Avoid or Use Alternate Drug. - selpercatinib
donepezil and selpercatinib both increase QTc interval. Avoid or Use Alternate Drug.
- sevoflurane
donepezil and sevoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
donepezil and siponimod both increase QTc interval. Avoid or Use Alternate Drug.
- solifenacin
donepezil and solifenacin both increase QTc interval. Avoid or Use Alternate Drug.
- sorafenib
donepezil and sorafenib both increase QTc interval. Avoid or Use Alternate Drug.
- sotalol
donepezil and sotalol both increase QTc interval. Avoid or Use Alternate Drug.
- tafenoquine
tafenoquine will increase the level or effect of memantine by Other (see comment). Avoid or Use Alternate Drug. Tafenoquine inhibits organic cation transporter-2 (OCT2) and multidrug and toxin extrusion (MATE) transporters in vitro. Avoid coadministration with OCT2 or MATE substrates. If coadministration cannot be avoided, monitor for substrate-related toxicities and consider dosage reduction if needed based on product labeling of the coadministered drug.
- tetrabenazine
donepezil and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.
- toremifene
donepezil and toremifene both increase QTc interval. Avoid or Use Alternate Drug.
- trazodone
donepezil and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension, donepezil. unspecified interaction mechanism. Avoid or Use Alternate Drug. Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. If possible, withdraw anticholinesterase agents at least 24 hours before initiating corticosteroid therapy.
- trilaciclib
trilaciclib will decrease the level or effect of memantine by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of trilaciclib (OCT2, MATE1, and MATE-2K inhibitor) with substrates where minimal increased concentration in kidney or blood may lead to serious or life-threatening toxicities.
- trimipramine
donepezil and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
Monitor Closely (167)
- acetazolamide
acetazolamide will increase the level or effect of memantine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- aclidinium
donepezil increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- albuterol
donepezil and albuterol both increase QTc interval. Use Caution/Monitor.
- alfuzosin
donepezil and alfuzosin both increase QTc interval. Use Caution/Monitor.
- aluminum hydroxide
aluminum hydroxide will increase the level or effect of memantine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- amantadine
memantine, amantadine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Combination may lead to additive adverse effects. If coadministration cannot be avoided, monitor for increased adverse effects such as agitation, dizziness and other CNS events.
- amifampridine
amifampridine and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.
- amiodarone
amiodarone will increase the level or effect of memantine by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor.
- amitriptyline
donepezil increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
donepezil and amitriptyline both increase QTc interval. Use Caution/Monitor. - amoxapine
donepezil increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- anticholinergic/sedative combos
donepezil increases and anticholinergic/sedative combos decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- apomorphine
donepezil and apomorphine both increase QTc interval. Use Caution/Monitor.
- arformoterol
donepezil and arformoterol both increase QTc interval. Use Caution/Monitor.
- aripiprazole
donepezil and aripiprazole both increase QTc interval. Use Caution/Monitor.
- artemether/lumefantrine
artemether/lumefantrine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- atomoxetine
donepezil and atomoxetine both increase QTc interval. Use Caution/Monitor.
- atracurium
donepezil increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atropine
donepezil increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atropine IV/IM
donepezil increases and atropine IV/IM decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- belladonna alkaloids
donepezil increases and belladonna alkaloids decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- belladonna and opium
donepezil increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- benztropine
donepezil decreases effects of benztropine by pharmacodynamic antagonism. Use Caution/Monitor.
- bethanechol
bethanechol and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.
- calcium carbonate
calcium carbonate will increase the level or effect of memantine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- carbachol
carbachol and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.
- carbamazepine
carbamazepine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cevimeline
cevimeline and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.
- cimetidine
cimetidine will increase the level or effect of memantine by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor.
cimetidine will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - ciprofloxacin
donepezil and ciprofloxacin both increase QTc interval. Use Caution/Monitor.
- digoxin
digoxin will increase the level or effect of memantine by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor.
- cisapride
donepezil and cisapride both increase QTc interval. Use Caution/Monitor.
- cisatracurium
donepezil increases and cisatracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- clarithromycin
clarithromycin will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- clomipramine
donepezil increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
donepezil and clomipramine both increase QTc interval. Use Caution/Monitor. - clozapine
donepezil and clozapine both increase QTc interval. Use Caution/Monitor.
- cyclizine
donepezil increases and cyclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cyclobenzaprine
donepezil increases and cyclobenzaprine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- darifenacin
donepezil increases and darifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dasatinib
donepezil and dasatinib both increase QTc interval. Use Caution/Monitor.
- degarelix
donepezil and degarelix both increase QTc interval. Use Caution/Monitor.
- desipramine
donepezil and desipramine both increase QTc interval. Use Caution/Monitor.
- desvenlafaxine
desvenlafaxine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mg
- deutetrabenazine
donepezil and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- dichlorphenamide
dichlorphenamide and donepezil both decrease serum potassium. Use Caution/Monitor.
- dicyclomine
donepezil increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diltiazem
diltiazem will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- diphenhydramine
donepezil increases and diphenhydramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dofetilide
dofetilide will increase the level or effect of memantine by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor.
- dolasetron
donepezil and dolasetron both increase QTc interval. Use Caution/Monitor.
- dosulepin
donepezil increases and dosulepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- doxepin
donepezil increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
donepezil and doxepin both increase QTc interval. Use Caution/Monitor. - echothiophate iodide
donepezil and echothiophate iodide both increase cholinergic effects/transmission. Use Caution/Monitor.
- efavirenz
efavirenz will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- eliglustat
donepezil and eliglustat both increase QTc interval. Use Caution/Monitor.
- erdafitinib
memantine increases levels of erdafitinib by decreasing renal clearance. Modify Therapy/Monitor Closely. Consider alternatives that are not OCT2 substrates or consider reducing the dose of OCT2 substrates based on tolerability.
- erythromycin base
erythromycin base will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- erythromycin lactobionate
erythromycin lactobionate will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- erythromycin stearate
erythromycin stearate will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- escitalopram
donepezil and escitalopram both increase QTc interval. Use Caution/Monitor.
- fesoterodine
donepezil increases and fesoterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fingolimod
fingolimod and donepezil both increase QTc interval. Use Caution/Monitor.
- flavoxate
donepezil increases and flavoxate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fluconazole
donepezil and fluconazole both increase QTc interval. Use Caution/Monitor.
- fluoxetine
fluoxetine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
donepezil and fluoxetine both increase QTc interval. Use Caution/Monitor. - fluphenazine
donepezil and fluphenazine both increase QTc interval. Use Caution/Monitor.
- fluvoxamine
donepezil and fluvoxamine both increase QTc interval. Use Caution/Monitor.
- formoterol
donepezil and formoterol both increase QTc interval. Use Caution/Monitor.
- fostemsavir
donepezil and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- galantamine
donepezil and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.
- gemifloxacin
donepezil and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- gemtuzumab
donepezil and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- gilteritinib
donepezil and gilteritinib both increase QTc interval. Use Caution/Monitor.
- glycopyrrolate
donepezil increases and glycopyrrolate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glycopyrrolate inhaled
donepezil increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- goserelin
donepezil and goserelin both increase QTc interval. Use Caution/Monitor.
- granisetron
donepezil and granisetron both increase QTc interval. Use Caution/Monitor.
- haloperidol
donepezil and haloperidol both increase QTc interval. Use Caution/Monitor.
- henbane
donepezil increases and henbane decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- homatropine
donepezil increases and homatropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- huperzine A
donepezil and huperzine A both increase cholinergic effects/transmission. Use Caution/Monitor.
- hydroxyzine
donepezil and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- hyoscyamine
donepezil increases and hyoscyamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hyoscyamine spray
donepezil increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- imipramine
donepezil increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
donepezil and imipramine both increase QTc interval. Use Caution/Monitor. - indacaterol, inhaled
donepezil and indacaterol, inhaled both increase QTc interval. Use Caution/Monitor.
- ipratropium
donepezil increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- itraconazole
donepezil and itraconazole both increase QTc interval. Use Caution/Monitor.
- ketoconazole
ketoconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lapatinib
donepezil and lapatinib both increase QTc interval. Use Caution/Monitor.
- letermovir
letermovir increases levels of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- leuprolide
donepezil and leuprolide both increase QTc interval. Use Caution/Monitor.
- levalbuterol
donepezil and levalbuterol both increase QTc interval. Use Caution/Monitor.
- levofloxacin
donepezil and levofloxacin both increase QTc interval. Use Caution/Monitor.
- levoketoconazole
levoketoconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lofepramine
donepezil increases and lofepramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- loperamide
donepezil and loperamide both increase QTc interval. Use Caution/Monitor.
- lumefantrine
lumefantrine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- maprotiline
donepezil increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
donepezil and maprotiline both increase QTc interval. Use Caution/Monitor. - meclizine
donepezil increases and meclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mefloquine
donepezil and mefloquine both increase QTc interval. Use Caution/Monitor.
- methscopolamine
donepezil increases and methscopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mifepristone
donepezil and mifepristone both increase QTc interval. Use Caution/Monitor.
- mirtazapine
donepezil and mirtazapine both increase QTc interval. Use Caution/Monitor.
- neostigmine
donepezil and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- nortriptyline
donepezil increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
donepezil and nortriptyline both increase QTc interval. Use Caution/Monitor. - octreotide
donepezil and octreotide both increase QTc interval. Use Caution/Monitor.
- ofloxacin
donepezil and ofloxacin both increase QTc interval. Use Caution/Monitor.
- olanzapine
donepezil and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- olodaterol inhaled
donepezil and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.
- onabotulinumtoxinA
donepezil increases and onabotulinumtoxinA decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- orphenadrine
donepezil increases and orphenadrine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- osilodrostat
osilodrostat and donepezil both increase QTc interval. Use Caution/Monitor.
- oxybutynin
donepezil increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxybutynin topical
donepezil increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxybutynin transdermal
donepezil increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pancuronium
donepezil increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- paroxetine
paroxetine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
donepezil and paroxetine both increase QTc interval. Use Caution/Monitor. - pasireotide
donepezil and pasireotide both increase QTc interval. Use Caution/Monitor.
- perphenazine
donepezil and perphenazine both increase QTc interval. Use Caution/Monitor.
- physostigmine
donepezil and physostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- pilocarpine
donepezil and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.
- posaconazole
donepezil and posaconazole both increase QTc interval. Use Caution/Monitor.
- pralidoxime
donepezil increases and pralidoxime decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- primaquine
donepezil and primaquine both increase QTc interval. Use Caution/Monitor.
- procainamide
memantine will increase the level or effect of procainamide by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor.
- prochlorperazine
donepezil and prochlorperazine both decrease QTc interval. Use Caution/Monitor.
- promethazine
donepezil and promethazine both decrease QTc interval. Use Caution/Monitor.
- propantheline
donepezil increases and propantheline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
donepezil increases and protriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
donepezil and protriptyline both increase QTc interval. Use Caution/Monitor. - pyridostigmine
donepezil and pyridostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- quinidine
quinidine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
quinidine will increase the level or effect of memantine by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor. - ramelteon
donepezil will increase the level or effect of ramelteon by unspecified interaction mechanism. Use Caution/Monitor. AUC and Cmax increased by 100% and 87% respectively.
- sodium bicarbonate
sodium bicarbonate will increase the level or effect of memantine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- ranolazine
donepezil and ranolazine both increase QTc interval. Use Caution/Monitor.
- rapacuronium
donepezil increases and rapacuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- rifabutin
rifabutin will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rifampin
rifampin will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rilpivirine
donepezil and rilpivirine both increase QTc interval. Use Caution/Monitor.
- risperidone
donepezil and risperidone both increase QTc interval. Use Caution/Monitor.
- rivastigmine
donepezil and rivastigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- rocuronium
donepezil increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- romidepsin
donepezil and romidepsin both increase QTc interval. Use Caution/Monitor.
- salmeterol
donepezil and salmeterol both increase QTc interval. Use Caution/Monitor.
- scopolamine
donepezil increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sertraline
donepezil and sertraline both increase QTc interval. Use Caution/Monitor.
- sodium citrate/citric acid
sodium citrate/citric acid will increase the level or effect of memantine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- sodium lactate
sodium lactate will increase the level or effect of memantine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- solifenacin
donepezil increases and solifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- St John's Wort
St John's Wort will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- succinylcholine
donepezil and succinylcholine both increase cholinergic effects/transmission. Use Caution/Monitor.
- sunitinib
donepezil and sunitinib both increase QTc interval. Use Caution/Monitor.
- tacrolimus
donepezil and tacrolimus both increase QTc interval. Use Caution/Monitor.
- telavancin
donepezil and telavancin both increase QTc interval. Use Caution/Monitor.
- tenofovir DF
tenofovir DF increases levels of memantine by decreasing renal clearance. Use Caution/Monitor. Potential for increased toxicity. .
- tiotropium
donepezil increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolterodine
donepezil increases and tolterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- triclabendazole
donepezil and triclabendazole both increase QTc interval. Use Caution/Monitor.
- trifluoperazine
donepezil and trifluoperazine both decrease QTc interval. Use Caution/Monitor.
- trihexyphenidyl
donepezil decreases effects of trihexyphenidyl by pharmacodynamic antagonism. Use Caution/Monitor.
- trimipramine
donepezil increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- triptorelin
donepezil and triptorelin both increase QTc interval. Use Caution/Monitor.
- trospium chloride
donepezil increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- umeclidinium bromide/vilanterol inhaled
donepezil and umeclidinium bromide/vilanterol inhaled both decrease QTc interval. Use Caution/Monitor.
- valbenazine
valbenazine and donepezil both increase QTc interval. Use Caution/Monitor.
- vandetanib
vandetanib increases levels of memantine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Vandetanib inhibits the uptake of substrates of organic cation transporter type 2 (OCT2).
- vardenafil
donepezil and vardenafil both increase QTc interval. Use Caution/Monitor.
Minor (141)
- aclidinium
donepezil decreases effects of aclidinium by pharmacodynamic antagonism. Minor/Significance Unknown.
- amiodarone
amiodarone will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- amobarbital
amobarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- anticholinergic/sedative combos
donepezil decreases effects of anticholinergic/sedative combos by pharmacodynamic antagonism. Minor/Significance Unknown.
- aprepitant
aprepitant will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- armodafinil
armodafinil will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- artemether/lumefantrine
artemether/lumefantrine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- asenapine
asenapine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- atazanavir
atazanavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- atracurium
donepezil decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- atropine
donepezil decreases effects of atropine by pharmacodynamic antagonism. Minor/Significance Unknown.
- atropine IV/IM
donepezil decreases effects of atropine IV/IM by pharmacodynamic antagonism. Minor/Significance Unknown.
- belladonna alkaloids
donepezil decreases effects of belladonna alkaloids by pharmacodynamic antagonism. Minor/Significance Unknown.
- belladonna and opium
donepezil decreases effects of belladonna and opium by pharmacodynamic antagonism. Minor/Significance Unknown.
- bethanechol
donepezil increases effects of bethanechol by pharmacodynamic synergism. Minor/Significance Unknown.
- bosentan
bosentan will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- budesonide
budesonide will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- bupropion
bupropion will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- butabarbital
butabarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- butalbital
butalbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- carbachol
donepezil increases effects of carbachol by pharmacodynamic synergism. Minor/Significance Unknown.
- celecoxib
celecoxib will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- cevimeline
donepezil increases effects of cevimeline by pharmacodynamic synergism. Minor/Significance Unknown.
- chloroquine
chloroquine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- cimetidine
cimetidine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- cisatracurium
donepezil decreases effects of cisatracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- conivaptan
conivaptan will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- cortisone
cortisone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- cyclizine
donepezil decreases effects of cyclizine by pharmacodynamic antagonism. Minor/Significance Unknown.
- cyclobenzaprine
donepezil decreases effects of cyclobenzaprine by pharmacodynamic antagonism. Minor/Significance Unknown.
- cyclosporine
cyclosporine will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- darifenacin
darifenacin will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
darifenacin will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
donepezil decreases effects of darifenacin by pharmacodynamic antagonism. Minor/Significance Unknown. - darunavir
darunavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- dasatinib
dasatinib will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- deferasirox
deferasirox will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- desipramine
donepezil increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- dexamethasone
dexamethasone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- DHEA, herbal
DHEA, herbal will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- dicyclomine
donepezil decreases effects of dicyclomine by pharmacodynamic antagonism. Minor/Significance Unknown.
- diphenhydramine
diphenhydramine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
donepezil decreases effects of diphenhydramine by pharmacodynamic antagonism. Minor/Significance Unknown. - dronedarone
dronedarone will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
dronedarone will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - duloxetine
duloxetine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- echothiophate iodide
donepezil increases effects of echothiophate iodide by pharmacodynamic synergism. Minor/Significance Unknown.
- eslicarbazepine acetate
eslicarbazepine acetate will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- etravirine
etravirine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- fesoterodine
donepezil decreases effects of fesoterodine by pharmacodynamic antagonism. Minor/Significance Unknown.
- flavoxate
donepezil decreases effects of flavoxate by pharmacodynamic antagonism. Minor/Significance Unknown.
- fluconazole
fluconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- fludrocortisone
fludrocortisone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- fosamprenavir
fosamprenavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- fosaprepitant
fosaprepitant will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- fosphenytoin
fosphenytoin will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- galantamine
donepezil increases effects of galantamine by pharmacodynamic synergism. Minor/Significance Unknown.
- glycopyrrolate
donepezil decreases effects of glycopyrrolate by pharmacodynamic antagonism. Minor/Significance Unknown.
- glycopyrrolate inhaled
donepezil decreases effects of glycopyrrolate inhaled by pharmacodynamic antagonism. Minor/Significance Unknown.
- grapefruit
grapefruit will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- griseofulvin
griseofulvin will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- haloperidol
haloperidol will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- henbane
donepezil decreases effects of henbane by pharmacodynamic antagonism. Minor/Significance Unknown.
- homatropine
donepezil decreases effects of homatropine by pharmacodynamic antagonism. Minor/Significance Unknown.
- huperzine A
donepezil increases effects of huperzine A by pharmacodynamic synergism. Minor/Significance Unknown.
- hydrochlorothiazide
hydrochlorothiazide will increase the level or effect of memantine by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- hydrocortisone
hydrocortisone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- hyoscyamine
donepezil decreases effects of hyoscyamine by pharmacodynamic antagonism. Minor/Significance Unknown.
- hyoscyamine spray
donepezil decreases effects of hyoscyamine spray by pharmacodynamic antagonism. Minor/Significance Unknown.
- imatinib
imatinib will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- indinavir
indinavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ipratropium
donepezil decreases effects of ipratropium by pharmacodynamic antagonism. Minor/Significance Unknown.
- isavuconazonium sulfate
isavuconazonium sulfate will increase the level or effect of memantine by Other (see comment). Minor/Significance Unknown. Isavuconazonium sulfate, an OCT2 inhibitor, may increase the effects or levels of OCT2 substrates.
- isoniazid
isoniazid will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- lapatinib
lapatinib will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- lumefantrine
lumefantrine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- maraviroc
maraviroc will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- marijuana
marijuana will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
marijuana will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - meclizine
donepezil decreases effects of meclizine by pharmacodynamic antagonism. Minor/Significance Unknown.
- metformin
memantine will increase the level or effect of metformin by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- methscopolamine
donepezil decreases effects of methscopolamine by pharmacodynamic antagonism. Minor/Significance Unknown.
- methyclothiazide
methyclothiazide will increase the level or effect of memantine by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- methylprednisolone
methylprednisolone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- metronidazole
metronidazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- miconazole vaginal
miconazole vaginal will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- midodrine
memantine will increase the level or effect of midodrine by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- nefazodone
nefazodone will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- nelfinavir
nelfinavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- neostigmine
donepezil increases effects of neostigmine by pharmacodynamic synergism. Minor/Significance Unknown.
- nevirapine
nevirapine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- nifedipine
nifedipine will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- nilotinib
nilotinib will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
nilotinib will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - ofloxacin
memantine will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- onabotulinumtoxinA
donepezil decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Minor/Significance Unknown.
- oxcarbazepine
oxcarbazepine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- oxybutynin
donepezil decreases effects of oxybutynin by pharmacodynamic antagonism. Minor/Significance Unknown.
- oxybutynin topical
donepezil decreases effects of oxybutynin topical by pharmacodynamic antagonism. Minor/Significance Unknown.
- oxybutynin transdermal
donepezil decreases effects of oxybutynin transdermal by pharmacodynamic antagonism. Minor/Significance Unknown.
- pancuronium
donepezil decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- pantothenic acid
pantothenic acid, donepezil. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown.
- parecoxib
parecoxib will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- pentobarbital
pentobarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- perphenazine
perphenazine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- phenobarbital
phenobarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- phenytoin
phenytoin will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- physostigmine
donepezil increases effects of physostigmine by pharmacodynamic synergism. Minor/Significance Unknown.
- pilocarpine
donepezil increases effects of pilocarpine by pharmacodynamic synergism. Minor/Significance Unknown.
- posaconazole
posaconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- pralidoxime
donepezil decreases effects of pralidoxime by pharmacodynamic antagonism. Minor/Significance Unknown.
- pramipexole
memantine will increase the level or effect of pramipexole by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- prednisone
prednisone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- primidone
primidone will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- procainamide
procainamide decreases effects of donepezil by pharmacodynamic antagonism. Minor/Significance Unknown.
- propafenone
propafenone will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- propantheline
donepezil decreases effects of propantheline by pharmacodynamic antagonism. Minor/Significance Unknown.
- pyridostigmine
donepezil increases effects of pyridostigmine by pharmacodynamic synergism. Minor/Significance Unknown.
- quinacrine
quinacrine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- quinine
memantine will increase the level or effect of quinine by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- quinupristin/dalfopristin
quinupristin/dalfopristin will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ranolazine
ranolazine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- rapacuronium
donepezil decreases effects of rapacuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- rifapentine
rifapentine will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ritonavir
ritonavir will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
ritonavir will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - rocuronium
donepezil decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- rufinamide
rufinamide will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- scopolamine
donepezil decreases effects of scopolamine by pharmacodynamic antagonism. Minor/Significance Unknown.
- secobarbital
secobarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- sertraline
sertraline will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- solifenacin
donepezil decreases effects of solifenacin by pharmacodynamic antagonism. Minor/Significance Unknown.
- succinylcholine
donepezil increases effects of succinylcholine by pharmacodynamic synergism. Minor/Significance Unknown.
- sulfamethoxazole
sulfamethoxazole will increase the level or effect of memantine by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- thioridazine
thioridazine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- tiotropium
donepezil decreases effects of tiotropium by pharmacodynamic antagonism. Minor/Significance Unknown.
- tipranavir
tipranavir will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- tolterodine
donepezil decreases effects of tolterodine by pharmacodynamic antagonism. Minor/Significance Unknown.
- topiramate
topiramate will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- trazodone
donepezil increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- triamterene
memantine will increase the level or effect of triamterene by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- trimethoprim
memantine will increase the level or effect of trimethoprim by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- trospium chloride
donepezil decreases effects of trospium chloride by pharmacodynamic antagonism. Minor/Significance Unknown.
- vecuronium
donepezil decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- venlafaxine
venlafaxine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- verapamil
verapamil will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
memantine will increase the level or effect of verapamil by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown. - voriconazole
voriconazole will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- zafirlukast
zafirlukast will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
Adverse Effects
>10% (donepezil)
Nausea (5-19%)
Diarrhea (8-15%)
Insomnia (5-14%)
Accident (7-13%)
Infection (11%)
1-10% (memantine)
Dizziness (7%)
Confusion (6%)
Headache (6%)
Constipation (5%)
Cough (4%)
Hypertension (4%)
Backache (3%)
Pain (3%)
Somnolence (3%)
Syncope (3%)
Vomiting (3%)
Dyspnea (2%)
Fatigue (2%)
1-10% (donepezil)
Headache (4-10%)
Vomiting (3-8%)
Cramping (3-8%)
Fatigue (3-8%)
Anorexia (3-7%)
Hypertension (3% )
Abnormal dreams (3%)
Hallucinations (3%)
Confusion (2%)
Syncope (2%)
Warnings
Contraindications
Hypersensitivity to memantine, donepezil, or piperidine derivatives
Cautions
Memantine
- Conditions that raise urine pH may decrease urinary elimination and increase plasma levels of memantine
- Use caution in cardiovascular disease, seizure disorder, ophthalmic disease, hepatic and/or renal impairment
Donepezil
- Risk of GI bleed: Patients receiving therapy should be monitored closely for symptoms of active or occult gastrointestinal bleeding, especially those at increased risk for developing ulcers, eg, those with a history of ulcer disease or those receiving concurrent nonsteroidal anti-inflammatory drugs (NSAIDs)
- Cholinesterase inhibitors are likely to exaggerate succinylcholine-type muscle relaxation during anesthesia
- Syncopal episodes reported in association with use of donepezil
- Cholinesterase inhibitors may have vagotonic effects on the sinoatrial and atrioventricular nodes manifesting as bradycardia or heart block
- May cause diarrhea, nausea, and vomiting; effects have been mild and transient, sometimes lasting one to three weeks, and have resolved during continued use of donepezil hydrochloride; observe patients closely at the initiating of therapy
- May cause anorexia and/or weight loss (dose dependent)
- Cholinomimetics may cause bladder outflow obstructions
- Cholinomimetics are believed to have some potential to cause generalized convulsions
- Cholinesterase inhibitors should be prescribed with care with history of asthma or obstructive pulmonary disease
Pregnancy & Lactation
Pregnancy Category: B (memantine); C (donepezil)
Lactation: Unknown if distributed in human breast milk
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.Pharmacology
Mechanism of Action
Memantine: Low- to moderate-affinity uncompetitive N-methyl-D-aspartate (NMDA) receptor (NMDAR) antagonist that binds preferentially to NMDAR-operated cation channels, blocking receptor only under conditions of excessive stimulation, with no effect on normal neurotransmission
Donepezil: Acetylcholinesterase inhibitor that causes an increase in concentrations of acetylcholine, which in turn enhances cholinergic neurotransmission
Absorption
Peak plasma time (memantine ER): 18 hr (with food); 25 hr (fasting)
Distribution
Protein bound (memantine ER): 45%
Vd (memantine ER): 9-11 L/kg
Metabolism
Memantine: Undergoes partial hepatic metabolism; CYP450 enzyme system does not play a significant role
Elimination
Half-life (memantine): 60-80 hr
Excretion (memantine): Predominantly in urine (48% unchanged); renal clearance involves active tubular secretion moderated by pH dependent tubular reabsorption
Administration
Oral Administration
May take with or without food
Capsules can be taken intact or may be opened, sprinkled on applesauce, and swallowed without chewing
The entire contents of each capsule should be consumed; the dose should not be divided
Except when opened and sprinkled on applesauce, the capsule should be swallowed capsule whole; do not divide, chew, or crush
Missed dose: If patient misses a single dose, the next dose should be taken as scheduled, without doubling up the dose
Images
Formulary
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.
