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Indications & Uses
Memantine and donepezil hydrochlorides extended-release capsules combine two medicines: memantine hydrochloride, an NMDA receptor antagonist, and donepezil hydrochloride, an acetylcholinesterase inhibitor. They are used to treat moderate to severe dementia of the Alzheimer's type in patients who are already stabilized on 10 mg of donepezil hydrochloride once daily.
Pharmacology
Memantine and donepezil hydrochlorides extended-release capsules contain two approved medicines, memantine hydrochloride extended-release and donepezil hydrochloride. Each of them is thought to work in a different way in Alzheimer's disease.
It has been hypothesized that persistent activation of NMDA receptors in the central nervous system by the excitatory amino acid glutamate contributes to the symptoms of Alzheimer's disease. Memantine is thought to have its effect by acting as a low to moderate affinity uncompetitive (open channel) NMDA receptor antagonist, which binds preferentially to the NMDA receptor-operated cation channels. There is no evidence that memantine prevents or slows neurodegeneration in patients with Alzheimer's disease.
Current theories on how the cognitive signs and symptoms of Alzheimer's disease arise put some of them down to a deficiency of cholinergic neurotransmission. Donepezil is thought to have its effect by strengthening cholinergic function. It does this by raising the concentration of acetylcholine in the central nervous system, through reversible inhibition of the breakdown (hydrolysis) of acetylcholine by acetylcholinesterase. As with memantine, there is no evidence that donepezil prevents or slows neurodegeneration in patients with Alzheimer's disease.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
For patients who take only donepezil hydrochloride 10 mg, the recommended starting dose of memantine and donepezil hydrochlorides extended-release capsules is 7 mg/10 mg, taken once daily in the evening. The dose is then raised in 7 mg steps until it reaches the recommended maintenance dose of 28 mg/10 mg. Leave at least one week between each increase.
Patients already taking memantine hydrochloride (10 mg twice daily or 28 mg extended-release once daily) together with donepezil hydrochloride 10 mg once daily can be switched straight to the 28 mg/10 mg capsules, taken once daily in the evening.
The capsules can be taken with or without food. They can be swallowed whole or sprinkled on applesauce. Do not divide, chew or crush them.
In severe renal impairment, the recommended maintenance dose of memantine and donepezil hydrochlorides extended-release capsules is 14 mg/10 mg once daily in the evening.
Side Effects
In trials of memantine hydrochloride extended-release 28 mg/day, the most common side effects were headache, diarrhea and dizziness. These happened in at least 5% of patients and more often than with placebo. For donepezil, the most common side effects were diarrhea, anorexia, vomiting, nausea and ecchymosis. These were seen in at least 5% of patients taking donepezil, at twice the placebo rate or more.
Cautions & Contraindications
Warnings & Precautions
Memantine and donepezil hydrochlorides extended-release is likely to exaggerate the muscle relaxation caused by succinylcholine-type drugs during anesthesia. It may also have vagotonic effects on the sinoatrial and atrioventricular nodes, which can show up as bradycardia or heart block. Watch patients for symptoms of active or occult gastrointestinal bleeding, especially those at increased risk of developing ulcers. The medicine can cause diarrhea, nausea and vomiting. It may also cause bladder outflow obstruction. Conditions that raise urine pH may reduce the urinary elimination of memantine, and this can lead to higher plasma levels of memantine.
Contraindications
Memantine and donepezil hydrochlorides extended-release capsules should not be given to anyone with a known hypersensitivity to memantine hydrochloride, donepezil hydrochloride or piperidine derivatives. The same applies to patients who are hypersensitive to any of the excipients used in the formulation.
Pregnancy & Breastfeeding
There isn't enough data to say what risk memantine and donepezil hydrochlorides extended-release capsules, or the two active ingredients on their own (memantine hydrochloride and donepezil hydrochloride), may carry for the development of a baby when used by pregnant women. Nor is anything known about whether memantine or donepezil passes into human milk. The effect on a breastfed infant is also unknown, and so is the effect of the capsules or their metabolites on milk production.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Pediatric Use: Safety and effectiveness of memantine and donepezil hydrochlorides extended-release in children have not been established.
Renal Impairment: No dosage adjustment is needed in people with mild or moderate renal impairment.
Hepatic Impairment: No dosage adjustment is needed in people with mild or moderate hepatic impairment. Memantine and donepezil hydrochlorides extended-release has not been studied in people with severe hepatic impairment.
Storage
Store Memantine + Donepezil below 30°C, away from light and moisture. Keep it out of the reach of children.
Common questions about Alzacare 7 mg+10 mg
What is Alzacare 7 mg+10 mg Capsule (Extended Release)?
Alzacare 7 mg+10 mg Capsule (Extended Release) is a medicine that contains Memantine + Donepezil. It is made by Renata PLC. It belongs to the Anti-Alzheimer drugs group of medicines.
What is Alzacare used for?
Memantine and donepezil hydrochlorides extended-release capsules combine two medicines: memantine hydrochloride, an NMDA receptor antagonist, and donepezil hydrochloride, an acetylcholinesterase inhibitor. They are used to treat moderate to severe dementia of the Alzheimer's type in patients who are already stabilized on 10 mg of donepezil hydrochloride once daily.
What are the side effects of Alzacare?
In trials of memantine hydrochloride extended-release 28 mg/day, the most common side effects were headache, diarrhea and dizziness. These happened in at least 5% of patients and more often than with placebo.
Can I take Alzacare during pregnancy or while breastfeeding?
There isn't enough data to say what risk memantine and donepezil hydrochlorides extended-release capsules, or the two active ingredients on their own (memantine hydrochloride and donepezil hydrochloride), may carry for the development of a baby when used by pregnant women. Nor is anything known about whether memantine or donepezil passes into human milk. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
How should I store Alzacare?
Store Memantine + Donepezil below 30°C, away from light and moisture. Keep it out of the reach of children.
Is there a cheaper medicine with the same ingredient?
Alzacare is already among the lowest-priced brands of Memantine + Donepezil at this strength.
Do I need a prescription for Alzacare?
Alzacare is a prescription (Rx) medicine. Take it as your doctor advises.