Galantamine Hydrobromide

A to Z Drug Facts

 Action May enhance cholinergic function by increasing acetylcholine.

 Indications Treatment of mild to moderate dementia of the Alzheimer type.

 Contraindications Standard considerations.

 Route/Dosage

ADULTS: PO 4 mg bid. May increase to 8 mg bid after 4 wk. A further increase to 12 mg bid may be attempted after a minimum of 4 wk at previous dose.

 Interactions

Bethanechol, succinylcholine: May act synergistically with galantamine. Erythromycin; ketoconazole; paroxetine: May elevate galantamine levels, increasing the risk of side effects.

 Lab Test Interferences None well documented.

 Adverse Reactions

cardiovascular Syncope; bradycardia; chest pain; hypertension. CNS: Dizziness; fatigue; headache; tremor; depression; insomnia; somnolence; agitation; confusion; anxiety; hallucinations. DERM: Purpura. GI: Nausea; vomiting; anorexia; diarrhea; abdominal pain; dyspepsia; constipation; flatulence. GU UTI; hematuria; urinary incontinence. HEMATOLOGIC Anemia. META: Weight decrease. RESPIRATORY Rhinitis; upper respiratory tract infection; bronchitis; coughing. OTHER: Injury; back pain; peripheral edema; asthenia; falling.

 Precautions

Pregnancy: Category B. Lactation: Undetermined. Children: Safety and efficacy not established. Concomitant medical conditions: As a result of increased cholinergic activity, other organ systems may be affected, possibly leading to bradycardia, obstructed bladder outflow, increased gastric acid secretion, or bronchoconstriction. Use with caution in patients susceptible to these effects. Hepatic or renal impairment: Use with caution in patients with moderately impaired function; not recommended in severe impairment.

 Administration/Storage

• Administer bid, preferably with morning and evening meal.
• Store at controlled room temperature (59° to 86°F). Keep container tightly closed.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Note current cardiac, GI, GU, or pulmonary conditions and history of liver disease or renal disease.
• Evaluate patient's mental status and function prior to initiation of therapy.
• Monitor patient for signs of improvement after therapy is started.
• Monitor patient for side effects of drug. Report any to physician.

 Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Advise patient, family or caregiver that this drug does not alter the Alzheimer process and that the effectiveness of the medication may lessen over time.
• Advise patient or caregiver that medication is taken bid, preferably with the morning and evening meal.
• Advise patient or caregiver that medication is started at a low dose and gradually increased (no more often than every 4 wk) as tolerated.
• Caution patient or caregiver that if medication has been stopped for several days or longer that the medication must be restarted at the lowest dose and gradually increased to the current dose.
• Advise patient or caregiver that nausea and vomiting are the most common side effects and that taking the medication with food and ensuring adequate fluid intake reduces these side effects. If nausea and vomiting become a problem, the patient or caregiver should inform the prescribing physician.
• Advise patient, family, or caregiver to not discontinue the drug or change the dose unless advised to do so by the physician.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts