Memantine XR
NAMENDA XR
Pronunciation: MEM-an-teen (na-MEN-da)
“Memaw’s Name reminder”
NaMenDA has the mechanism in its name → NMDA receptor antagonist
What it isExtended-release 28 mg NMDA antagonist; symptomatic treatment of moderate-to-severe Alzheimer disease.
Why this oneCompared with IR, it is a once daily, sprinklable capsule with higher steady-state exposure than 10 mg BID IR.
What limits itDizziness and confusion can worsen function; renal impairment or urine alkalinization can raise exposure.
FDA-approved for
- Alzheimer disease (moderate-severe) (2010)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Moderate to severe dementia of the Alzheimer's type | Adults | 7 mg QD | 28 mg QD | 28 mg QD |
Titration Increase in 7 mg increments; minimum interval between increases is one week
Renal Severe impairment (CrCl 5–29 mL/min): maintenance/maximum dose 14 mg/day; no adjustment for mild-moderate
Hepatic No dose adjustment for mild-moderate impairment; not studied in severe impairment
Instructions
- Take once daily, with or without food
- Swallow whole, or open capsule and sprinkle contents on applesauce and swallow (do not divide dose)
- Do not divide, chew, or crush
- If several doses are missed, resume at lower dose and retitrate
Available strengths
- ER cap 7, 14, 21, 28 mg
- tab 5, 10 mg
- sol 2 mg/mL
Cautions
- Conditions that raise urine pH may decrease urinary elimination and increase plasma memantine levels
Adverse reactions
- Headache
- Diarrhea
- Dizziness
- Constipation
- Somnolence
- Hypertension
Pregnancy No adequate well-controlled studies; not teratogenic in animals up to highest doses tested; use only if benefit justifies risk
Lactation Unknown whether excreted in human milk; exercise caution
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 7 mg | ER cap | 30 qd | $9.37 | offered |
| 14 mg | ER cap | 30 qd | $10.35 | offered |
| 21 mg | ER cap | 30 qd | $10.69 | offered |
| 28 mg | ER cap | 30 qd | $10.27 | offered |
Other forms: Memantine (NAMENDA)
NO BOXED WARNINGS
Principal riskLittle; usually well tolerated
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityBradycardia, syncope or GI effects for symptomatic drugs; anti-amyloid agents add edema/hemorrhage risk.
Open Memantine XR in the interactive console ↗
Memory aids: interaction avatars
