Name /bks_53161_deglins_md_disk/memantine 02/17/2014 07:22AM Plate # 0-Composite pg 1 # 1

1 current use of drugs or diets that cause alkaline urine; Conditions thatqurine pH in-
cluding severe urinary tract infections or renal tubular acidosis (lead topexcretion
PDF Page #1
memantine (me-man-teen) andqlevels); OB, Lactation, Pedi: Safety not established.
Ebixa, Namenda, Namenda XR Adverse Reactions/Side Effects
Classification CNS: dizziness, fatigue, headache, sedation. CV: hypertension. Derm: rash. GI: di-
Therapeutic: anti-Alzheimers agents arrhea, weight gain. GU: urinary frequency. Hemat: anemia.
Pharmacologic: N-methyl-D-aspartate antagonist
Pregnancy Category B Interactions
Drug-Drug: Medications thatqurine pH (e.g. carbonic anhydrase inhibi-
tors, sodium bicarbonate) maypexcretion andqblood levels.
Indications
Moderate to severe dementia/neurocognitive disorder associated with Alzheimers Route/Dosage
disease. PO (Adults): Immediate-release 5 mg once daily initially,qat weekly intervals
to 10 mg/day (5 mg twice daily), then 15 mg/day (5 mg once daily, 10 mg once daily
Action as separate doses), then to target dose of 20 mg/day (10 mg twice daily); Extended-
Binds to CNS N-methyl-D-aspartate (NMDA) receptor sites, preventing binding of glu- release 7 mg once daily,qat weekly intervals by 7 mg/day to target dose of 28 mg
tamate, an excitatory neurotransmitter. Therapeutic Effects: Decreased symp- once daily.
toms of dementia/cognitive decline. Does not slow progression. Cognitive enhance-
Renal Impairment
ment. Does not cure disease.
(Adults): CCr 5 29 mL/min Immediate-release: Target dose is 10 mg/day (5
Pharmacokinetics mg twice daily); Extended-release: Target dose is 14 mg once daily.
Absorption: Well absorbed after oral administration. NURSING IMPLICATIONS
Distribution: Unknown.
Metabolism and Excretion: 57 82% excreted unchanged in urine by active tu- Assessment
bular secretion moderated by pH dependent tubular reabsorption. Remainder me- Assess cognitive function (memory, attention, reasoning, language, ability to per-
tabolized; metabolites are not pharmacologically active. form simple tasks) periodically during therapy.
Half-life: 60 80 hr. Lab Test Considerations: May cause anemia.
TIME/ACTION PROFILE (blood levels) Potential Nursing Diagnoses
ROUTE ONSET PEAK DURATION Disturbed thought process (Indications)
Risk for injury (Side Effects)
PO unknown 37 hr 12 hr Impaired environmental interpretation syndrome
PO-ER unknown 912 hr 24 hr
Implementation
Contraindications/Precautions Dose increases should occur no more frequently than weekly.
Contraindicated in: Hypersensitivity. To switch from Namenda to Namenda XR, patients taking 10 mg twice daily of Na-
Use Cautiously in: Severe renal impairment (pdose); Concurrent use of other menda tablets may be switched to Namenda XR 28 mg once daily capsules the day
NMDA antagonists (amantadine, rimantadine, ketamine, dextromethorphan); Con- following the last dose of a 10 mg Namenda tablet Patients with renal impairment
Canadian drug name. Genetic Implication. CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough Discontinued.
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may use the same procedure to switch from Namenda 5 mg twice daily to Na- PDF Page #2
menda XR 14 mg once daily.
PO: May be administered without regard to food.
Administer oral solution using syringe provided. Do not dilute or mix with other
fluids.
Swallow extended release capsules whole; do not crush, chew, or divide. Capsules
may be opened, sprinkled on applesauce, and swallowed. Entire contents of each
capsule should be consumed; do not divide dose.
Patient/Family Teaching
Instruct patient and caregiver on how and when to administer memantine and how
to titrate dose. Take missed doses as soon as remembered but not just before next
dose; do not double doses. Advise patient and caregiver to read Patient Instruc-
tions sheet.
Caution patient and caregiver that memantine may cause dizziness.
Advise patient and caregiver to notify health care professional of all Rx or OTC
medications, vitamins, or herbal products being taken and to consult with health
care professional before taking other medications.
Teach patient and caregivers that improvement in cognitive functioning may take
months; degenerative process is not reversed.
Evaluation/Desired Outcomes
Improvement in neurocognitive decline (memory, attention, reasoning, language,
ability to perform simple tasks) in patients with Alzheimers disease.
Why was this drug prescribed for your patient?

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