Galantamine

Galantamine is used to treat the symptoms of Alzheimer's disease (AD; a brain disease that affects memory, thinking, and behavior). Galantamine is in a class of medications called acetylcholinesterase inhibitors. It works by increasing the amount of a certain naturally occurring substance in the brain.

Galantamine comes as a tablet, an extended-release (long-acting) capsule, and a solution (liquid) to take by mouth. Take the tablets and liquid twice a day with food. Take the extended-release capsules once a day in the morning with food. Take galantamine at around the same time(s) every day.

Take galantamine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the extended-release capsules whole; do not crush or chew them.

Your doctor will probably start you on a low dose of galantamine and gradually increase your dose, not more often than once every 4 weeks.

Galantamine controls the symptoms of Alzheimer's disease but does not cure it. Continue to take galantamine even if you feel well. Do not stop taking galantamine without talking to your doctor.

Before you take galantamine oral solution for the first time, read the written instructions that come with it. Ask your doctor or pharmacist to show you how to take the oral solution. To take the oral solution, follow these steps:

1. Open the child-proof cap by pushing the cap down while turning it to the left. Remove the cap.
2. Pull the pipette (the tube that you use to measure the dose of galantamine) out of its case.
3. Place the pipette fully into the bottle of galantamine.
4. While holding the bottom ring of the pipette, turn the bottle upside down, pull the pipette plunger up to the marking that shows the dose your doctor prescribed.
5. Hold the bottom ring of the pipette and remove the pipette from the bottle. Be careful not to push the plunger in.
6. Prepare 3 to 4 ounces (about 1/2 cup [90 to 120 milliliters]) of any non-alcoholic beverage. Empty all the medicine from the pipette into the beverage by pushing the plunger all the way in.
7. Stir the beverage well.
8. Drink all of the mixture right away.
9. Put the plastic cap back on the bottle of galantamine and turn the cap to the right to close the bottle.
10. Rinse the empty pipette by putting its open end into a glass of water, pulling the plunger out, and pushing the plunger in to remove the water.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking galantamine,

• tell your doctor and pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods, or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• you should know that some medications should not be taken with galantamine. Other medications may cause dosing changes or extra monitoring when taken with galantamine. Make sure you have discussed any medications you are currently taking or plan to take before starting galantamine with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking galantamine, please get the advice of your doctor or pharmacist.
• you should know the following nonprescription or herbal products may interact with galantamine: cimetidine, dimenhydrinate, meclizine, brompheniramine, cholorpheniramine, diphenhydramine, doxylamine, loperamide, aspirin, ibuprofen and naproxen. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking galantamine. Do not start any of these medications while taking galantamine without discussing with your healthcare provider.
• tell your doctor if you have or have ever had bleeding in your stomach or intestines; an ulcer; heart problems or an irregular, slow, or fast heartbeat, seizures; difficulty urinating; asthma;chronic obstructive pulmonary disease (a group of lung disease including chronic bronchitis or emphysema); or kidney or liver or heart disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking galantamine, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking galantamine.

Unless your doctor tells you otherwise, continue your normal diet. Ensure you are drinking plenty of fluids such as water while you are taking galantamine.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. If you miss several doses in a row, call your doctor before restarting.

Galantamine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• diarrhea
• loss of appetite
• stomach pain
• heartburn
• weight loss
• extreme tiredness
• dizziness  
• headache
• tremor
• depression  

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately or get emergency medical treatment:

• rash, blistering or peeling of the skin, skin pain, swelling of lips, mouth, throat, tongue or face
• feeling weak, confusion, fainting, shortness of breath, chest pain, slowed heart beat
• bloody or black, tarry stools, vomiting blood or vomit that looks like coffee grounds, severe abdominal pain
• difficulty urinating or weak urine flow, painful urination, blood in urine, or fever
• seizures
• new or worsening breathing problems, difficulty breathing, or shortness of breath

Galantamine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not freeze.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• muscle weakness or twitching
• nausea
• vomiting
• stomach cramps
• drooling
• teary eyes
• increased urination
• need to have a bowel movement
• sweating
• slowed, fast, or irregular heartbeat
• lightheadedness
• dizziness
• fainting
• slowed breathing
• collapse
• loss of consciousness
• seizures
• dry mouth
• chest pain
• hallucinations (seeing things or hearing voices that do not exist)

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

• Razadyne^® (formerly available as Reminyl^®)^¶
• Razadyne^® ER^¶