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Razadyne Fact Sheet

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Medication Name (brand): 
Medication Name (clinical): 

Janssen; patent expires 2008.

  • Mild to moderate Alzheimer’s dementia.

  • Used off-label for both mild cognitive impairment and severe dementia.


Acetylcholinesterase inhibitor, stimulates nicotine receptors.

  • Supplied as:

  • Immediate-release (IR): 4 mg white, 8 mg pink, 12 mg orange-brown tablets.
  • Extended-release (ER): 8 mg white, 16 mg pink, 24 mg orange-brown capsules.
  • Oral solution available in 4 mg/mL strength.
  • IR: start at 4 mg BID, increase to 8 mg BID after four weeks. If needed, increase to 12 mg BID after another 4 weeks.
  • ER: start at 8 mg QD, increase to 16 mg QD after four weeks. If needed, increase to 24 mg QD after another 4 weeks.
  • You may need to decrease the dose in both hepatic and renal impairment.

Side Effects: 
  • Most common: nausea, appetite loss, diarrhea.

  • FDA advisory noted a higher mortality rate in patients with mild cognitive impairment (MCI) taking Razadyne (1.5%) versus those randomly assigned to placebo (0.5%).
  • May aggravate stomach ulcers (potential class effect of all cholinesterase inhibitors).
  • Pregnancy risk category B.

Drug-drug Interactions: 
  • Paxil and other 2D6 inhibitors may increase levels.

  • 3A4 inducers such as Tegretol may decrease levels

  • Metabolized hepatically by P450 2D6 and 3A4.

  • Half-life 7 hours.


Most clinicians use the ER version exclusively because it can be dosed once a day.

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