PHA 3611/3612 Clinical Pharmacy Clerkship

Generic Name: Galantamine Brand Name: Reminyl® Manufacturer: Shire Pharmaceuticals and Janssen Cilag (http://www.janssenpharmaceutica.be/index_N.asp) Summary: Galantamine hydrobromide, a phenanthrene alkaloid, is a reversible, competitive acetylcholinesterase inhibitor that is structurally unrelated to other acetylcholinesterase inhibitors (e.g, donepezil, rivastigmine, tacrine). Galantamine hydrobromide is used for the treatment of mild to moderate dementia of the Alzheimer's type (Alzheimer's disease). Efficacy has been demonstrated in many randomized, placebo-controlled studies of 3-6 months' duration utilizing a dual outcome assessment strategy. The recommended starting dosage of galantamine is 4 mg twice daily. Increases of 8 mg/day, in two divided doses, may be made after at least four weeks at a given dosage. A maintenance dosage of 16-24 mg/day, in two divided doses, has been found to be effective and reasonably tolerated. Comparison of the different reversible inhibitors of acetylcholinesterase used in mild to moderate dementia in Alzheimer’s disease, galantamine has extra mode of action to stimulate nicotinic receptors to release more acetylcholine in the brain.