Memantine

ATC code

N06DX01

Therapeutic class

Anti-dementia drug · N-methyl-D-aspartate (NMDA) receptor antagonist

Forms

film-coated tablet, oral solution

Brand names

Memantine Mylan (EU) · Ebixa (EU) · Namenda (US) · Memantina Cinfa (ES)

Overall confidence

high

Regulatory sources consulted

Approved indications

Treatment of patients with moderate to severe Alzheimer’s disease.

Contraindications

Absolute

Hypersensitivity to the active substance or to any of the excipients.

Clinical warnings

Caution is recommended in patients with epilepsy, a history of convulsions or patients with predisposing factors for epilepsy. — EMA
Factors that may raise urine pH (changes in diet, renal tubular acidosis, severe urinary tract infections) may necessitate careful monitoring of the patient, as they decrease the elimination of memantine. — EMA

Drug interactions

HighAmantadineN04BB01
Mechanism: Pharmacodynamic antagonism at the NMDA-receptor. Concomitant use may lead to an increased incidence and severity of CNS adverse effects (pharmacotoxic psychosis).
Recommendation: The concomitant use of memantine and amantadine, ketamine or dextromethorphan should be avoided.
EMA SPC
ModerateHydrochlorothiazideC03AA03
Mechanism: Unknown mechanism. Memantine may reduce the exposure of hydrochlorothiazide (HCT).
Recommendation: Monitor for efficacy of hydrochlorothiazide. Dose adjustment may be necessary.
EMA SPC

Adverse events

Common (≥1%)

dizziness · headache · somnolence · hypertension · dyspnoea · constipation · balance disorder

Rare but serious

seizures · cardiac failure · pancreatitis · hepatitis · psychotic reactions

Pregnancy and lactation

There are no clinical data on exposed pregnancies available for memantine. It should not be used during pregnancy unless clearly necessary. Breast-feeding is not recommended during treatment.