Memanta Dosage/Direction for Use

Treatment should be initiated and supervised by a physician experienced in the diagnosis and treatment of Alzheimer's dementia. Therapy should only be started if a caregiver is available who will regularly monitor the intake of the medicinal product by the patient. Diagnosis should be made according to the current guidelines. The tolerance and dosing of memantine should be reassessed on regular basis, preferably within the three months after start of treatment.
Thereafter, the clinical benefit of memantine and the patient's tolerance of treatment should be reassessed on a regular basis according to current guidelines. Maintenance treatment can be continued for as long as a therapeutic benefit is favourable and the patient tolerates treatment with memantine. Discontinuation of memantine should be considered when evidence of a therapeutic effect is no longer present of if the patient does not tolerate treatment.
Memantine tablets should be administered once a day and should be taken at the same time every day.
The film-coated tablets can be taken with or without food.
Adults: Dose Titration: The recommended starting dose is 5 mg per day, which is stepwise increased over the first 4 weeks of treatment reaching the recommended maintenance dose as follows: Week 1(day 1-7): The patient should take half a 10 mg tablet equivalent to 5 mg per day, for 7 days.
Week 2 (day 8-14): The patient should take one 10 mg tablet equivalent to 10 mg per day, for 7 days.
Week 3 (day 15-21): The patient should take one and a half 10 mg tablet equivalent to 15 mg per day, for 7 days.
Form Week 4 on: The patient should take two 10 mg tablet equivalent to 20 mg per day, once a day.
Maintenance Dose: The recommended maintenance dose is 20 mg per day.
Elderly: On the basis of the clinical studies, the recommended dose for patients over the age of 65 years is 20 mg per day (two 10 mg tablets) as previously described.
Paediatric population: Memantine is not recommended for use in children below 18 years due to a lack of data on safety and efficacy.
Renal impairment: In patients with mildly impaired renal function (creatinine clearance 50-80 mL/min) no dosage adjustment is required. In patients with moderate renal impairment (creatinine clearance 30-49 mL/min) daily dose should be 10 mg. If tolerated well after at least 7 days of treatment, the dose could be increased up to 20 mg/day according to standard titration scheme. In patients with severe renal impairment (creatinine clearance 5-29 mL/min) daily dose should be 10 mg per day.
Hepatic impairment: In patient with mild to moderate hepatic impaired function (Child-Pugh A and Child-Pugh B) no dosage adjustment is needed. No data on the use of memantine in patients with severe hepatic impairment are available. Administration of memantine is not recommended in patients with severe hepatic impairment.