Cimantin Special Precautions

Caution is recommended with patients suffering from epilepsy.
Concomitant use of N-methyl-D-aspartate (NMDA)-antagonist such as amantadine, ketamine or dextromethorphan should be avoided. These compounds act at the same receptor system as Memantine, and therefore adverse drug reactions (mainly CNS-related) may be more frequent or more pronounced (see also Interactions).
Some factors that may raise urine pH may necessitate careful monitoring of the patient. These factors include drastic changes in diet, e.g. from a carnivore to a vegetarian diet, or a massive ingestion of alkalising gastric buffers. Also, urine pH may be elevated by states of renal tubulary acidosis (RTA) or severe infections of the urinary tract with Proteus bacteria.
Patients with recent myocardial infarction, uncompensated congestive heart failure (NYHA III-IV), and uncontrolled hypertension should be closely supervised.
The safety of concomitant administration of Memantine and neuroleptics, benzodiazepines and antidepressant must be considered.
Effects on ability to drive and use machines: Moderate to severe Alzheimer's disease usually causes impairment of driving performance and compromises the ability to use machinery. Furthermore, Memantine has minor to moderate influence on the ability to drive and use machines such that outpatients should be warned to take special care.