Indications for Galantamine Oral Solution:
Mild to moderate Alzheimer's dementia.
Give with AM & PM meals. Initially 4mg twice daily; if well-tolerated, increase to maintenance dose 8mg twice daily (16mg/day) after minimum of 4 weeks; may attempt further increase to 12mg twice daily (24mg/day) after minimum of 4 weeks. Re-titrate if interrupted for >3 days. Moderate hepatic or renal impairment (CrCl 9–59mL/min): usual max 16mg/day.
Galantamine Oral Solution Warnings/Precautions:
Discontinue at the first sign of skin rash, unless not drug-related; consider alternative therapy if serious skin reactions occur. Conduction disorders (eg, bradycardia, AV block). History of ulcer disease. Bladder outflow obstruction. Asthma. COPD. Seizures. Monitor for active or occult GI bleed, respiratory or neurological effects, and patient's weight. Maintain adequate hydration. Severe hepatic or renal impairment (CrCl <9mL/min): not recommended. Pregnancy. Nursing mothers.
Galantamine Oral Solution Classification:
Reversible acetylcholinesterase inhibitor (benzazepine deriv).
Galantamine Oral Solution Interactions:
Potentiates neuromuscular blockers (eg, succinylcholine), cholinesterase inhibitors, cholinergic agonists (eg, bethanechol). Antagonizes anticholinergics. Caution with drugs that slow heart rate. May be potentiated by ketoconazole, cimetidine, paroxetine, fluoxetine, erythromycin, possibly others that affect CYP2D6 or CYP3A4. Monitor for GI bleed with NSAIDs.
Nausea, vomiting, diarrhea, dizziness, headache, decreased appetite, anorexia, weight loss, syncope, bradycardia, heart block, seizures; serious skin reactions (eg, Stevens-Johnson syndrome).
Generic Drug Availability:
Tabs—60; Soln—contact supplier; ER caps—30