Galantamine (reminil)

A similar treatment to Aricept (donepezil) and Exalon (Revastigmine). One of the messengers that carry instructions around the brain is called acetylcholine. Research has shown that there is not enough of this chemical in the brains of people who suffer with Alzheimer’s disease. An enzyme called aceycholinesterase breaks this chemical down and the drug galantamine (reminil) can reduce this break down. Therefore Galantamine increases the amount of acetylcholine in the brain. Galantamine also enhances the action of acetylcholine on some receptors in the brain. This means that the speed at which the disease develops may be slowed down. Galantamine does not stop or cure Alzheimer’s dementia; but improve early symptoms of the disease

Galantamine (reminil) treatment should be initiated by the consultant or a specialist clinician, although GPs may continue prescribing. Patients should be started on initially at 4mg tablets taking twice daily and increased after 4 weeks to 8mg tablets twice daily. Maintaince dosage should be one 8mg tablet to one 12mg tablet twice daily

Galantamine has proven to be more effective for patients with mild to moderate symptoms of Alzheimer’s Disease. Alzheimer patients tend to have greater behavioural, sensorial, global and daily living activity improvements in higher dosage

Not all the Alzheimer’s patients improve with Galantamine, especially patients with more severe symptoms, so assessment may be done by your specialist clinician and if, after 3 months of treatment, patients do not respond, Galantamine could be discontinued

The main side effects of Galantamine are similar to Rivastigmine and Donezepil. Galantamine could produce: gastrointestinal side effects (nausea, transient vomiting, and diarrhoea), fatigue, dizziness, muscle aching, weight loss, insomnia, urinary incontinence, sweating and vision disorders. They are usually mild and tend to minimise as treatment continues. You will find a list of less common side effects in the leaflet given with the medication. Please make sure you have a copy the first time the medication is prescribed

Galantamine has achieved significant improvement in cognitive and global symptoms, especially at higher dosage. Galantamine also improves activities of daily living in those patients and significantly reduces the requirement for caregiver assistance with activities of daily living

Galantimine should never be prescribed for patients with:
• with severe liver or kidney impairment
• women who breastfeed
• with urinary retention or gastrointestinal obstruction
• with disturbance of the galactose metabolism.

It should also be prescribed with caution for:
• for pregnant women
• gastric or duodenal ulcers (and those at risk of developing ulcers)
• suffer from arrhythmias ( such as sick sinus syndrome or other conduction abnormalities)
• have history of asthma or chronic obstructive pulmonary disease
• suffer from mild to moderate liver or kidney problems

If other medication is required, such as cold remedies, do not forget to check with your pharmacist

Reproduced with kind permission of Maria Sanchez our Consultant Pharmacist