Dosing & Uses
Dosage Forms & Strengths
tablet
- 4mg
- 8mg
- 12mg
capsule, extended-release
- 8mg
- 16mg
- 24mg
oral solution
- 4mg/mL
Alzheimer Disease
Indicated for mild-to-moderate demential of the Alzheimer's type
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (3)
- mefloquine
mefloquine increases toxicity of galantamine by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.
- ponesimod
ponesimod, galantamine. 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.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension, galantamine. 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.
Monitor Closely (89)
- aclidinium
galantamine increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- amifampridine
amifampridine and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.
- amitriptyline
galantamine increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- amoxapine
galantamine increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- anticholinergic/sedative combos
galantamine increases and anticholinergic/sedative combos decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- artemether/lumefantrine
artemether/lumefantrine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- atracurium
galantamine increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atropine
galantamine increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atropine IV/IM
galantamine increases and atropine IV/IM decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- belladonna alkaloids
galantamine increases and belladonna alkaloids decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- belladonna and opium
galantamine increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- benztropine
galantamine decreases effects of benztropine by pharmacodynamic antagonism. Use Caution/Monitor.
- bethanechol
bethanechol and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.
- bupropion
bupropion will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- carbachol
carbachol and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.
- carbamazepine
carbamazepine will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cevimeline
cevimeline and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.
- cimetidine
cimetidine will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cisatracurium
galantamine 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 galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- clomipramine
galantamine increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cyclizine
galantamine increases and cyclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cyclobenzaprine
galantamine increases and cyclobenzaprine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- darifenacin
galantamine increases and darifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- desvenlafaxine
desvenlafaxine will increase the level or effect of galantamine 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
- dichlorphenamide
dichlorphenamide and galantamine both decrease serum potassium. Use Caution/Monitor.
- dicyclomine
galantamine increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- diphenhydramine
galantamine increases and diphenhydramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- donepezil
donepezil and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.
- dosulepin
galantamine increases and dosulepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- doxepin
galantamine increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- echothiophate iodide
echothiophate iodide and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.
- erythromycin base
erythromycin base will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- erythromycin lactobionate
erythromycin lactobionate will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- erythromycin stearate
erythromycin stearate will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fesoterodine
galantamine increases and fesoterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- flavoxate
galantamine increases and flavoxate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fluoxetine
fluoxetine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- glycopyrrolate
galantamine increases and glycopyrrolate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glycopyrrolate inhaled
galantamine increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- henbane
galantamine increases and henbane decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- homatropine
galantamine increases and homatropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- huperzine A
galantamine and huperzine A both increase cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine
galantamine increases and hyoscyamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hyoscyamine spray
galantamine increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- imipramine
galantamine increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ipratropium
galantamine increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- isoniazid
isoniazid will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ketoconazole
ketoconazole will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- letermovir
letermovir increases levels of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- levoketoconazole
levoketoconazole will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lofepramine
galantamine increases and lofepramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lumefantrine
lumefantrine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- maprotiline
galantamine increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- meclizine
galantamine increases and meclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methscopolamine
galantamine increases and methscopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nefazodone
nefazodone will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- neostigmine
galantamine and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- nortriptyline
galantamine increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- onabotulinumtoxinA
galantamine increases and onabotulinumtoxinA decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- orphenadrine
galantamine increases and orphenadrine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxybutynin
galantamine increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxybutynin topical
galantamine increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- oxybutynin transdermal
galantamine increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pancuronium
galantamine 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 galantamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- physostigmine
galantamine and physostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- pilocarpine
galantamine and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.
- pralidoxime
galantamine increases and pralidoxime decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- propantheline
galantamine increases and propantheline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
galantamine increases and protriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pyridostigmine
galantamine and pyridostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- quinidine
quinidine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- rapacuronium
galantamine 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 galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rifampin
rifampin will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rivastigmine
galantamine and rivastigmine both increase cholinergic effects/transmission. Use Caution/Monitor.
- rocuronium
galantamine increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- scopolamine
galantamine increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- solifenacin
galantamine 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 galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- succinylcholine
galantamine and succinylcholine both increase cholinergic effects/transmission. Use Caution/Monitor.
- tiotropium
galantamine increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tolterodine
galantamine increases and tolterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trihexyphenidyl
galantamine decreases effects of trihexyphenidyl by pharmacodynamic antagonism. Use Caution/Monitor.
- trimipramine
galantamine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trospium chloride
galantamine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- vecuronium
galantamine increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Minor (128)
- aclidinium
galantamine decreases effects of aclidinium by pharmacodynamic antagonism. Minor/Significance Unknown.
- amiodarone
amiodarone will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- amobarbital
amobarbital will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- anticholinergic/sedative combos
galantamine decreases effects of anticholinergic/sedative combos by pharmacodynamic antagonism. Minor/Significance Unknown.
- aprepitant
aprepitant will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- armodafinil
armodafinil will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- artemether/lumefantrine
artemether/lumefantrine will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- asenapine
asenapine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- atazanavir
atazanavir will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- atracurium
galantamine decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- atropine
galantamine decreases effects of atropine by pharmacodynamic antagonism. Minor/Significance Unknown.
- atropine IV/IM
galantamine decreases effects of atropine IV/IM by pharmacodynamic antagonism. Minor/Significance Unknown.
- belladonna alkaloids
galantamine decreases effects of belladonna alkaloids by pharmacodynamic antagonism. Minor/Significance Unknown.
- belladonna and opium
galantamine decreases effects of belladonna and opium by pharmacodynamic antagonism. Minor/Significance Unknown.
- bethanechol
galantamine increases effects of bethanechol by pharmacodynamic synergism. Minor/Significance Unknown.
- bosentan
bosentan will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- budesonide
budesonide will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- butabarbital
butabarbital will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- butalbital
butalbital will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- carbachol
galantamine increases effects of carbachol by pharmacodynamic synergism. Minor/Significance Unknown.
- celecoxib
celecoxib will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- cevimeline
galantamine increases effects of cevimeline by pharmacodynamic synergism. Minor/Significance Unknown.
- chloroquine
chloroquine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- cimetidine
cimetidine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- cisatracurium
galantamine decreases effects of cisatracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- conivaptan
conivaptan will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- cortisone
cortisone will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- cyclizine
galantamine decreases effects of cyclizine by pharmacodynamic antagonism. Minor/Significance Unknown.
- cyclobenzaprine
galantamine decreases effects of cyclobenzaprine by pharmacodynamic antagonism. Minor/Significance Unknown.
- darifenacin
darifenacin will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
darifenacin will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
galantamine decreases effects of darifenacin by pharmacodynamic antagonism. Minor/Significance Unknown. - darunavir
darunavir will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- dasatinib
dasatinib will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- deferasirox
deferasirox will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- desipramine
galantamine 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 galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- DHEA, herbal
DHEA, herbal will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- dicyclomine
galantamine decreases effects of dicyclomine by pharmacodynamic antagonism. Minor/Significance Unknown.
- diltiazem
diltiazem will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- diphenhydramine
diphenhydramine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
galantamine decreases effects of diphenhydramine by pharmacodynamic antagonism. Minor/Significance Unknown. - donepezil
donepezil increases effects of galantamine by pharmacodynamic synergism. Minor/Significance Unknown.
- dronedarone
dronedarone will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
dronedarone will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - duloxetine
duloxetine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- echothiophate iodide
galantamine increases effects of echothiophate iodide by pharmacodynamic synergism. Minor/Significance Unknown.
- efavirenz
efavirenz will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- eslicarbazepine acetate
eslicarbazepine acetate will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- etravirine
etravirine will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- fesoterodine
galantamine decreases effects of fesoterodine by pharmacodynamic antagonism. Minor/Significance Unknown.
- flavoxate
galantamine decreases effects of flavoxate by pharmacodynamic antagonism. Minor/Significance Unknown.
- fluconazole
fluconazole will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- fludrocortisone
fludrocortisone will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- fosamprenavir
fosamprenavir will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- fosaprepitant
fosaprepitant will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- fosphenytoin
fosphenytoin will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- glycopyrrolate
galantamine decreases effects of glycopyrrolate by pharmacodynamic antagonism. Minor/Significance Unknown.
- glycopyrrolate inhaled
galantamine decreases effects of glycopyrrolate inhaled by pharmacodynamic antagonism. Minor/Significance Unknown.
- grapefruit
grapefruit will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- griseofulvin
griseofulvin will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- haloperidol
haloperidol will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- henbane
galantamine decreases effects of henbane by pharmacodynamic antagonism. Minor/Significance Unknown.
- homatropine
galantamine decreases effects of homatropine by pharmacodynamic antagonism. Minor/Significance Unknown.
- huperzine A
galantamine increases effects of huperzine A by pharmacodynamic synergism. Minor/Significance Unknown.
- hydrocortisone
hydrocortisone will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- hyoscyamine
galantamine decreases effects of hyoscyamine by pharmacodynamic antagonism. Minor/Significance Unknown.
- hyoscyamine spray
galantamine decreases effects of hyoscyamine spray by pharmacodynamic antagonism. Minor/Significance Unknown.
- imatinib
imatinib will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- indinavir
indinavir will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ipratropium
galantamine decreases effects of ipratropium by pharmacodynamic antagonism. Minor/Significance Unknown.
- lapatinib
lapatinib will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- lumefantrine
lumefantrine will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- maraviroc
maraviroc will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- marijuana
marijuana will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
marijuana will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - meclizine
galantamine decreases effects of meclizine by pharmacodynamic antagonism. Minor/Significance Unknown.
- methscopolamine
galantamine decreases effects of methscopolamine by pharmacodynamic antagonism. Minor/Significance Unknown.
- methylprednisolone
methylprednisolone will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- metronidazole
metronidazole will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- miconazole vaginal
miconazole vaginal will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- nelfinavir
nelfinavir will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- neostigmine
galantamine increases effects of neostigmine by pharmacodynamic synergism. Minor/Significance Unknown.
- nevirapine
nevirapine will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- nifedipine
nifedipine will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- nilotinib
nilotinib will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
nilotinib will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - onabotulinumtoxinA
galantamine decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Minor/Significance Unknown.
- oxcarbazepine
oxcarbazepine will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- oxybutynin
galantamine decreases effects of oxybutynin by pharmacodynamic antagonism. Minor/Significance Unknown.
- oxybutynin topical
galantamine decreases effects of oxybutynin topical by pharmacodynamic antagonism. Minor/Significance Unknown.
- oxybutynin transdermal
galantamine decreases effects of oxybutynin transdermal by pharmacodynamic antagonism. Minor/Significance Unknown.
- pancuronium
galantamine decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- pantothenic acid
pantothenic acid, galantamine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown.
- parecoxib
parecoxib will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- pentobarbital
pentobarbital will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- perphenazine
perphenazine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- phenobarbital
phenobarbital will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- phenytoin
phenytoin will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- physostigmine
galantamine increases effects of physostigmine by pharmacodynamic synergism. Minor/Significance Unknown.
- pilocarpine
galantamine increases effects of pilocarpine by pharmacodynamic synergism. Minor/Significance Unknown.
- posaconazole
posaconazole will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- pralidoxime
galantamine decreases effects of pralidoxime by pharmacodynamic antagonism. Minor/Significance Unknown.
- prednisone
prednisone will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- primidone
primidone will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- procainamide
procainamide decreases effects of galantamine by pharmacodynamic antagonism. Minor/Significance Unknown.
- propafenone
propafenone will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- propantheline
galantamine decreases effects of propantheline by pharmacodynamic antagonism. Minor/Significance Unknown.
- pyridostigmine
galantamine increases effects of pyridostigmine by pharmacodynamic synergism. Minor/Significance Unknown.
- quinacrine
quinacrine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- quinupristin/dalfopristin
quinupristin/dalfopristin will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ranolazine
ranolazine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- rapacuronium
galantamine decreases effects of rapacuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- rifapentine
rifapentine will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ritonavir
ritonavir will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
ritonavir will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. - rocuronium
galantamine decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- rufinamide
rufinamide will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- scopolamine
galantamine decreases effects of scopolamine by pharmacodynamic antagonism. Minor/Significance Unknown.
- secobarbital
secobarbital will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- sertraline
sertraline will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- solifenacin
galantamine decreases effects of solifenacin by pharmacodynamic antagonism. Minor/Significance Unknown.
- succinylcholine
galantamine increases effects of succinylcholine by pharmacodynamic synergism. Minor/Significance Unknown.
- thioridazine
thioridazine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- tiotropium
galantamine decreases effects of tiotropium by pharmacodynamic antagonism. Minor/Significance Unknown.
- tipranavir
tipranavir will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- tolterodine
galantamine decreases effects of tolterodine by pharmacodynamic antagonism. Minor/Significance Unknown.
- topiramate
topiramate will decrease the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- trazodone
galantamine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- trospium chloride
galantamine decreases effects of trospium chloride by pharmacodynamic antagonism. Minor/Significance Unknown.
- vecuronium
galantamine decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- venlafaxine
venlafaxine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- verapamil
verapamil will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- voriconazole
voriconazole will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- zafirlukast
zafirlukast will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
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
Postmarketing Reports
Hallucinations
Seizures
Extrapyramidal disorder
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
Dose-related increase in risk of syncope reported
Renamed Razadyne from Reminyl in the US to avoid confusion with Amaryl
Serious skin reactions (Stevens-Johnson syndrome and acute generalized exanthematous pustulosis) reported; inform patients and caregivers that therapy should be discontinued at first appearance of skin rash, unless rash is clearly not drug-related; do not resume treatment and consider alternative therapy if signs or symptoms suggest a serious skin reaction
As a cholinesterase inhibitor, therapy is likely to exaggerate neuromuscular blocking effects of succinylcholine-type and similar neuromuscular blocking agents during anesthesia
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; cholinesterase inhibitors have vagotonic effects on sinoatrial and atrioventricular nodes, leading to bradycardia and AV block; bradycardia and all types of heart block have been reported in patients both with and without known underlying cardiac conduction abnormalities
Cholinomimetics may be expected to increase gastric acid secretion due to increased cholinergic activity; monitor patients closely for symptoms of active or occult gastrointestinal bleeding, especially those with increased risk for developing ulcers, eg, those with a history of ulcer disease or patients using concurrent nonsteroidal anti-inflammatory drugs (NSAIDs)
Cholinomimetics may cause bladder outflow obstruction
Use caution when prescribing to patients with a history of severe asthma or obstructive pulmonary disease; monitor respiratory function closely for occurrence of respiratory adverse effects
Cholinesterase inhibitors are believed to have potential to cause generalized convulsions; seizure activity may also be a manifestation of Alzheimer’s disease; patients with Alzheimer’s disease should be monitored closely for seizures while receiving therapy
An increase in cholinergic tone may worsen symptoms related to extrapyramidal disorders
Due to pharmacological properties, therapy may cause nausea, vomiting, diarrhea, anorexia, and weight loss; monitor patient’s weight during therapy
Individuals with mild cognitive impairment demonstrate isolated memory impairment greater than expected for their age and education, but do not meet current diagnostic criteria for Alzheimer’s disease
Pregnancy & Lactation
Pregnancy
There are no adequate data on developmental risk associated with use in pregnant women
Animal data
- In studies conducted in animals, administration of galantamine during pregnancy resulted in developmental toxicity (increased incidence of morphological abnormalities and decreased growth in offspring) at doses similar to or greater than those used clinically
Lactation
There are no data on presence of ddrug in human milk, effects on breastfed infant, or on milk production
Developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for drug and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition
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
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
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Razadyne ER oral - | 8 mg capsule |  | |
| Razadyne ER oral - | 24 mg capsule |  | |
| Razadyne ER oral - | 16 mg capsule |  | |
| galantamine oral - | 12 mg tablet |  | |
| galantamine oral - | 4 mg tablet |  | |
| galantamine oral - | 8 mg tablet |  | |
| galantamine oral - | 8 mg tablet |  | |
| galantamine oral - | 12 mg tablet |  | |
| galantamine oral - | 4 mg tablet |  | |
| galantamine oral - | 16 mg capsule |  | |
| galantamine oral - | 24 mg capsule |  | |
| galantamine oral - | 4 mg tablet |  | |
| galantamine oral - | 12 mg tablet |  | |
| galantamine oral - | 16 mg capsule |  | |
| galantamine oral - | 8 mg capsule |  | |
| galantamine oral - | 8 mg capsule |  | |
| galantamine oral - | 24 mg capsule |  | |
| galantamine oral - | 8 mg tablet |  | |
| galantamine oral - | 4 mg tablet |  | |
| galantamine oral - | 8 mg tablet |  | |
| galantamine oral - | 24 mg capsule | | |
| galantamine oral - | 16 mg capsule | | |
| galantamine oral - | 8 mg capsule | | |
| galantamine oral - | 16 mg capsule |  | |
| galantamine oral - | 8 mg capsule |  | |
| galantamine oral - | 16 mg capsule |  | |
| galantamine oral - | 8 mg capsule |  | |
| galantamine oral - | 4 mg/mL solution |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
galantamine oral
GALANTAMINE - ORAL
(ga-LAN-ta-meen)
COMMON BRAND NAME(S): Razadyne, Reminyl
USES: Galantamine is used to treat mild to moderate confusion (dementia) related to Alzheimer's disease. It does not cure Alzheimer's disease, but it may improve memory, awareness, and the ability to perform daily functions. This medication works by restoring the balance of certain natural substances (neurotransmitters) in the brain.
HOW TO USE: Take this medication by mouth with food as directed by your doctor, usually twice daily with the morning and evening meals. Drink plenty of fluids with this medication unless instructed otherwise. To lower your risk of side effects, your dosage will be gradually increased to your target dose. Your dosage is based on your medical condition and response to therapy.If you are using the liquid form of this drug, read the manufacturer's instruction sheet that comes with the bottle. Follow the directions exactly. Use the measuring device that comes with the product to measure out your dose. Mix your dose of medication in about 4 ounces (120 milliliters) of nonalcoholic beverage, stir, and drink the entire mixture. Ask your pharmacist about any information that is unclear.If you stop taking galantamine for longer than 3 days, your doctor may direct you to restart this medication at a low dose and gradually increase your dose to reduce your risk of side effects. Carefully follow your doctor's instructions.Use this medication regularly in order to get the most benefit from it. Do not stop taking it or increase the dosage unless your doctor instructs you to do so.It may take at least 4 weeks of continued use before the full benefit of this drug takes effect.Inform your doctor if your condition worsens.
SIDE EFFECTS: Nausea, vomiting, diarrhea, dizziness, drowsiness, loss of appetite, and weight loss may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: unusually slow heartbeat, difficult urination.Get medical help right away if you have any very serious side effects, including: seizures, black/bloody stools, vomit that looks bloody or like coffee grounds, severe stomach/abdominal pain, fast/irregular heartbeat, severe dizziness, fainting.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking galantamine, tell your doctor or pharmacist if you are allergic to it; or to daffodil plants; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems, kidney problems, stomach/intestinal problems (such as ulcers, bleeding), heart problems (such as sick sinus syndrome, bradycardia, AV block, arrhythmias), breathing/lung problems (such as severe asthma, COPD-chronic obstructive pulmonary disease), seizures, problems urinating (such as due to enlarged prostate).This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Galantamine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using galantamine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using galantamine safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: anticholinergic drugs (such as atropine, diphenhydramine, scopolamine, tolterodine), beta-blockers (including metoprolol, propranolol), cholinergic drugs (such as bethanechol), cholinesterase inhibitors (such as neostigmine), digoxin.Other medications can affect the removal of galantamine from your body, which may affect how galantamine works. Examples include amitriptyline, azole antifungals (such as ketoconazole), quinidine, SSRI antidepressants (such as paroxetine), among others.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include muscle weakness or twitching, severe stomach cramping, slow or shallow breathing, slow/fast/irregular heartbeat, fainting, and seizures.
NOTES: Do not share this medication with others.Since galantamine may cause loss of appetite and weight loss, your doctor should monitor your weight before and during treatment with this medication.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Do not freeze. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised September 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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