galantamine (Rx)

Brand and Other Names:Razadyne ER
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Dosing & Uses

AdultPediatric

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

Next:

Interactions

Interaction Checker

and galantamine

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            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.

              • 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.

              • pilocarpine ophthalmic

                galantamine and pilocarpine ophthalmic 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 (129)

              • 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.

              • 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.

              • modafinil

                modafinil will decrease 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.

              • pilocarpine ophthalmic

                galantamine increases effects of pilocarpine ophthalmic 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.

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              Adverse Effects

              >10%

              Nausea (20-25%)

              Diarrhea (11-15%)

              Vomiting (11-15%)

              1-10%

              Abdominal pain

              Anorexia

              Muscle cramp

              Fatigue

              Dizziness

              Headache

              Weight loss

              Depression

              Insomnia

              UTI

              Somnolence

              Anemia

              Syncope

              Bradycardia

              Other Information

              Complete atrioventricular block

              Postmarketing Reports

              Hallucinations

              Seizures

              Extrapyramidal disorder

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              Warnings

              Contraindications

              Hypersensitivity

              Cautions

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

              Not recommended in severe hepatic or renal impairment

              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

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              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.

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              Pharmacology

              Mechanism of Action

              Derived from daffodil bulbs

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

              Pharmacokinetics

              Half-Life: 7 hr

              Peak Plasma Time: 1 hr

              Bioavailability: 90%

              Protein Bound: 18%

              Vd: 175 L

              Metabolism: CYP2D6 & CYP3A4

              Excretion: Urine

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              galantamine oral
              -
              4 mg/mL solution
              galantamine oral
              -
              4 mg tablet
              galantamine oral
              -
              12 mg tablet
              galantamine oral
              -
              8 mg tablet
              galantamine oral
              -
              12 mg tablet
              galantamine oral
              -
              8 mg capsule
              galantamine oral
              -
              16 mg capsule
              galantamine oral
              -
              4 mg tablet
              galantamine oral
              -
              12 mg tablet
              galantamine oral
              -
              8 mg tablet
              galantamine oral
              -
              24 mg capsule
              galantamine oral
              -
              8 mg capsule
              galantamine oral
              -
              16 mg capsule
              galantamine oral
              -
              12 mg tablet
              galantamine oral
              -
              8 mg tablet
              galantamine oral
              -
              8 mg capsule
              galantamine oral
              -
              16 mg capsule
              galantamine oral
              -
              8 mg tablet
              galantamine oral
              -
              4 mg tablet
              galantamine oral
              -
              12 mg tablet
              galantamine oral
              -
              8 mg tablet
              galantamine oral
              -
              4 mg tablet
              galantamine oral
              -
              24 mg capsule
              galantamine oral
              -
              16 mg capsule
              galantamine oral
              -
              8 mg capsule
              galantamine oral
              -
              24 mg capsule
              galantamine oral
              -
              16 mg capsule
              galantamine oral
              -
              8 mg capsule
              Razadyne ER oral
              -
              24 mg capsule
              Razadyne ER oral
              -
              16 mg capsule
              Razadyne ER oral
              -
              8 mg capsule

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              galantamine oral

              GALANTAMINE EXTENDED-RELEASE CAPSULE - ORAL

              (ga-LAN-tuh-meen)

              COMMON BRAND NAME(S): Razadyne ER

              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, usually once daily in the morning with breakfast or as directed by your doctor. This medication may be taken on an empty stomach if necessary. 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. Do not take more than the maximum recommended dose of 24 milligrams per day.Swallow the capsules whole. Do not crush or chew the capsules. Doing so can destroy the long action of the drug and may increase side effects.If you stop taking galantamine for several days, consult your doctor or pharmacist before restarting it. Your dosage should be reduced to lower the risk of side effects. Your dosage should then be increased gradually. Follow all your doctor's dosing instructions exactly.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 persist or worsen, 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: fainting, 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 (e.g., ulcers, bleeding), heart problems (e.g., sick sinus syndrome, bradycardia, AV block, arrhythmias), breathing/lung problems (e.g., severe asthma, COPD-chronic obstructive pulmonary disease), seizures, problems urinating (e.g., 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 (e.g., atropine, diphenhydramine, scopolamine, tolterodine), aspirin (high doses used for arthritis), beta-blockers (including metoprolol, propranolol), cholinergic drugs (e.g., bethanechol), cholinesterase inhibitors (e.g., neostigmine), digoxin, long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, naproxen), drugs affecting liver enzymes that remove galantamine from your body (such as azole antifungals including ketoconazole, amitriptyline, SSRI antidepressants including paroxetine, quinidine).Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as aspirin, ibuprofen, or naproxen) which, if taken together with galantamine, may increase your risk for stomach/intestinal bleeding. Low-dose aspirin, as prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually 81-162 milligrams a day), should be continued. Consult your doctor or pharmacist for more details.

              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 at 77 degrees F (25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines 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 for more details about how to safely discard your product.

              Information last revised September 2021. Copyright(c) 2021 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.

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              Formulary

              FormularyPatient Discounts

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

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

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
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              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

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

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