Memantine ER/Donepezil: Difference between revisions
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MDElliottMD (talk | contribs) Create Namzaric combo scaffold |
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| halflife = ~60–80 h (memantine); ~70 h (donepezil) | | halflife = ~60–80 h (memantine); ~70 h (donepezil) | ||
| bioavailability = ~100% both components | | bioavailability = ~100% both components | ||
| pregnancy = Not relevant (geriatric | | pregnancy = Not relevant (geriatric problem) | ||
| legal = Rx-only in US | | legal = Rx-only in US | ||
| mechanism = Donepezil: reversible AChE inhibitor — increases synaptic acetylcholine. Memantine: uncompetitive low-affinity NMDA receptor antagonist — dampens pathological glutamate overactivation while preserving normal synaptic signaling. Targets two distinct mechanisms in Alzheimer's. | | mechanism = Donepezil: reversible AChE inhibitor — increases synaptic acetylcholine. Memantine: uncompetitive low-affinity NMDA receptor antagonist — dampens pathological glutamate overactivation while preserving normal synaptic signaling. Targets two distinct mechanisms in Alzheimer's. | ||
Revision as of 01:37, 19 May 2026
Combined cholinesterase inhibitor + NMDA antagonist
Memantine ER / Donepezil
Namzaric
Namzaric is a once-daily fixed-dose combination of memantine ER and donepezil, for patients with moderate-to-severe Alzheimer's already stable on both components. The convenience is real — daily pill burden cut roughly in half. The trade-off is reduced ability to titrate each component independently.
Cognitive function (MMSE/MoCA); GI tolerability; heart rate (donepezil bradycardia risk); renal function (memantine adjustment).
Take in the evening. Capsule may be opened and sprinkled on applesauce. Do not start this combo in patients not already stable on both components.
Memantine, Donepezil, Galantamine, Rivastigmine
Experience
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Problems
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+ Add a problemTitration strategies
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Effects
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Pharmacokinetics
Absorption
Both ~100% absorbed.Distribution
Memantine ~45% protein bound; donepezil ~96%.Metabolism
Memantine: minimal hepatic. Donepezil: CYP2D6, CYP3A4.Elimination
Memantine: renal (mostly unchanged). Donepezil: renal and hepatic.Interactions
No interactions reported yet.
Monitoring
Patient counseling
Relevant anecdote
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Relevant Literature
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See also
References
Summary
Classes
Combined cholinesterase inhibitor + NMDA antagonist
Common uses
Moderate-to-severe Alzheimer's dementia0
Pharmacy
Starting dose
For patients already stable on memantine 28 mg/d + donepezil 10 mg/d — switch to one capsule daily of equivalent strength
Preparations
7/10, 14/10, 21/10, 28/10 mg ER capsules (memantine ER / donepezil)
US FDA Max
28/10 mg/d
Pharmacology
Routes
Oral (capsule whole or opened/sprinkled on applesauce)
Onset
Component effects accumulate over weeks
Duration
24 h
Half-life
~60–80 h (memantine); ~70 h (donepezil)
Bioavailability
~100% both components
Pregnancy
Not relevant (geriatric problem)
Legal status
Rx-only in US
Purported mechanism
Donepezil: reversible AChE inhibitor — increases synaptic acetylcholine. Memantine: uncompetitive low-affinity NMDA receptor antagonist — dampens pathological glutamate overactivation while preserving normal synaptic signaling. Targets two distinct mechanisms in Alzheimer's.