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Galantamine

Galantamine a tertiary alkaloid, is a competitive and reversible inhibitor of acetylcholinesterase.

INDICATIONS : Treatment of mild to moderate dementia of the Alzheimer's type.

CONTRAINDICATIONS : Hypersensitivity, severe hepatic and severe renal impairment.

SAFETY PROFILE : Caution required in patient with an increased risk for developing ulcer. Not recommended in patients with GI obstruction, uri¬nary outflow obstruction, recovering from gastrointes¬tinal surgery. Alzheimer Patient's weight should be monitored. Driving or use of machinery especially during the first week is not recommended.

ADVERSE EFFECTS: Nausea , vomiting, abdomi¬nal pain, fatigue, bradycardia, tremor, loss of weight, anxiety, UTI, constipation, upper respiratory infec¬tion, hypertension, cardiac failure, gastroenteritis thrombocytopenia.

DRUGS INTERACTIONS : Drugs that are potent inhibitors for CYP2D6 or CYP3A4 may increase the bioavailability of galantamine. DOSAGE: Starting dose 4mg b.i.d.(8mg/Day) increased by 8mg a day after a minimum of 4 weeks treatment if the previous dose is well tolerated.

A further increase to 12mg twice a day (24mg/ day) should be attempted only after a minimum of 4 weeks at the previous dose.

Dosage should be taken twice a day, preferably with morning and evening meal. Adequate fluid intake during treatment is must.