Vexlin Special Precautions

Information for Patients and Care givers: Care givers should be instructed in the recommended administration (twice per day for doses above 5 mg) and dose escalation (minimum interval of one week between dose increases).
Neurological Conditions: Seizures: Memantine has not been systematically evaluated in patients with a seizure disorder. In clinical trials of Memantine, seizures occurred in 0.2% of patients treated with Memantine and 0.5% of patients treated with placebo.
Genitourinary Conditions: Conditions that raise urine pH may decrease the urinary elimination of memantine resulting in increased plasma levels of memantine.
Special Populations: Hepatic Impairment: Memantine undergoes partial hepatic metabolism, with about 48% of administered dose excreted in urine as unchanged drug or as the sum of parent drug and the N-glucuronide conjugate (74%). No dosage adjustment is needed in patients with mild or moderate hepatic impairment. Memantine should be administered with caution to patients with severe hepatic impairment.
Renal Impairment: No dosage adjustment is needed in patients with mild or moderate renal impairment. A dosage reduction is recommended in patients with severe renal impairment.