Dementa

Adults:

For adults and older patients, the recommended maintenance dose of Memantine is 20 mg every day. To lower the risk of side effects, this dose should be reached through gradual upward titration, increasing by 5 mg per week over three weeks, so that the maintenance dose of 20 mg per day is reached from the start of week 4, following this dosage guideline. In week 1, the dose everyday is 5 mg (1 tablet) in the morning and no dose at night. In week 2, the dose everyday is 5 mg (1 tablet) in the morning and 5 mg (1 tablet) at night. In week 3, the dose everyday is 10 mg (2 tablets) in the morning and 5 mg (1 tablet) at night. From week 4 onwards, the dose everyday is 10 mg (2 tablets) in the morning and 10 mg (2 tablets) at night. If a dose is missed, simply wait and take the next dose at the usual time. Do not double the dose to make up for the missed one. In patients with moderate renal impairment, meaning a creatinine clearance of 30 to 49 ml per minute, the daily dose should be 10 mg, equivalent to 1 ml of solution or two downward strokes. If this is well tolerated after at least 7 days of treatment, the dose may be increased up to 20 mg per day according to the standard titration scheme described above. In patients with severe renal impairment, meaning a creatinine clearance of 5 to 29 ml per minute, the daily dose should be 10 mg, equivalent to 1 ml of solution or two downward strokes, per day. In patients with mild or moderate hepatic impairment, no dosage adjustment is needed. Memantine is not recommended for patients with severe hepatic impairment. Memantine is not recommended for children under 18 years of age, as there is not enough data on its safety and efficacy in this age group.