Products
Galantamine is commercially available in the form of sustained-release capsules (Reminyl, generic). It has been approved in many countries since 2000. Generics entered the market in 2014.
Structure and properties
Galantamine (C17H21NO3, Mr = 287.4 g/mol) is an alkaloid found in the Caucasian snowdrop, among other species, and is now produced synthetically. In pharmaceuticals, it is present as galantamine hydrobromide, a white powder that is sparingly soluble in water.
Effects
Galantamine (ATC N06DA04) is a selective, competitive, and reversible inhibitor of acetylcholinesterase. It is indirectly parasympathomimetic (cholinergic), improving symptoms of Alzheimer’s disease. It also improves neurotransmission by allosterically modulating nicotinic acetylcholine receptors.
Indications
Symptomatic treatment of patients with mild to moderate dementia of the Alzheimer’s type.
Dosage
According to the SmPC. The sustained-release capsules are taken once daily in the morning with breakfast.
Contraindications
- Hypersensitivity
- Severe renal and hepatic insufficiency
Full precautions can be found in the drug label.
Interactions
Galantamine is metabolized by CYP2D6 and CYP3A4. Corresponding interactions are possible. Drug interactions may further occur with parasympathomimetics, parasympatholytics, digoxin, beta-blockers, and muscle relaxants.
Adverse effects
The most common potential adverse effects include nausea and vomiting. Other common adverse effects include decrease in appetite, slow pulse, hallucinations, depression, high blood pressure, muscle cramps, fall, fatigue, weakness, malaise, syncope, dizziness, tremor, headache, drowsiness, lethargy, abdominal pain, diarrhea, dyspepsia, and increased sweating.
