Forest Labs; market exclusivity expires 2008
Moderate to severe Alzheimer’s dementia.
Off-label use for mild to moderate dementia.
NMDA antagonist, works by preventing too much glutamate from damaging neurons.
5 mg tan and 10 mg gray tablets
2 mg/mL oral solution
Start at 5 mg QD for 1 week, then 5 mg BID for 1 week, then 10 mg QAM and 5 mg QPM for 1 week, and finally 10 BID (target dose).
No dose adjustment needed in hepatic impairment; decrease dose in severe renal impairment.
Most common: dizziness, sedation, transient confusion.
Pregnancy risk category B.
No significant interactions reported.
Metabolized partly by liver; half is excreted unchanged in the urine.
Namenda mildly augments the effects of Aricept in clinical trials (JAMA 2004;291:317-324).
Probably less effective for mild dementia; this indication was rejected by the FDA in 2005.