Alzheimer’s Disease Medications: Fact Sheet

Several prescription drugs are currently approved by the U.S. Food and Drug Administration (FDA) to treat people who have been diagnosed with Alzheimer’s disease. Treating the symptoms of Alzheimer’s can provide patients with comfort, dignity and independence for a longer period of time and can encourage and assist their caregivers as well. It is important to understand that none of these medications stops the disease itself.

Treatment for mild to Moderate Alzheimer’s:

Medications called cholinesterase inhibitors are prescribed for mild to moderate Alzheimer’s disease. These drugs may help delay or prevent symptoms from becoming worse for a limited time and may help control some behavioral symptoms. The medication include Razadyne (galantamine), Exelon (rivastigmine), and Aricept (donepezil).

Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimer’s disease but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimer’s progresses, the brain produces less and less acetylcholine; therefore, cholinesterase inhibitors may eventually lose their effect.

No published study directly compares these drugs. Because they work in a similar way, switching from one of these drugs to another probably will not produce significantly different results. However, an Alzheimer’s patient may respond better to one drug than another.

Treatment for Moderate to Severe Alzheimer’s:

A medication known as Namenda (memantine), a N-methyl D-aspartate (NMDA) antagonist, is prescribed to treat moderate to severe Alzheimer’s disease. This drug’s main effect is to delay progression of some of the symptoms of moderate to severe Alzheimer’s. It may allow patients to maintain certain daily functions a little longer than they would without the medication. For example, Namenda may help a patient in the later stages of the disease maintain his or her ability to use the bathroom independently for several more months, a benefit for both patients and caregivers.

The FDA has also approved Aricept and Namzaric, a combination of Namenda and donepezil, for the treatment of moderate to severe Alzheimer’s disease.

Namenda is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work very differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.

Dosage and Side Effects:

Doctors usually start patients at low drug doses and gradually increase the dosage based on how well a patient tolerates the drug. There is some evidence that certain patients may benefit from higher doses of the cholinesterase inhibitors. However, the higher the dose, the more likely are side effects. The recommendation effective dosages of drugs prescribed to treat the symptoms of Alzheimer’s and the drugs’ possible side effects are summarized in the table.

Patients should be monitored when a drug is started. Report any unusual symptoms to the prescribing doctor right away. It is important to follow the doctor’s instructions when taking any medication, including vitamins and herbal supplements. Also, let the doctor know before adding or changing any medications.

Testing New Alzheimer’s Drugs: Clinical trials are the best way to find out if promising new treatments are safe and effective in humans. Volunteers are needed for many Alzheimer’s trials conducted around the United States. To learn more, talk with your doctor or visit the ADEAR Center’s listing of clinical trials at http://www.nia.nih.gov/alzheimers/clinical-trials. More information is available  at http://www.nia.nih.gov/alzheimers/volunteer.

For more information:

To learn about support groups, research centers, research studies and publications about Alzheimer’s disease, contact the following resources:

Alzheimer’s Disease Education and Referral (ADEAR) Center

1-800-438-4380 (toll free)

adear@nia.nih.gov

http://www.nia.nih.gov/alzheimers

The National Institute on Aging’s ADEAR Center offers information and publications for families, caregivers and professionals on diagnosis, treatment, patient care, caregiver needs, long term care, education, training and research related to Alzheimer’s disease. Staff members answer telephone, email and written requests and make referrals to local and national resources. Visit the ADEAR website to learn more about Alzheimer’s and other dementias, find clinical trails and sign up for email alerts.

Alzheimer’s Association

1-800-272-3900 (toll-free)

1-866-403-3073 (TTY/toll-free)

info@alz.org

http://www.alz.org

Alzheimer’s Foundation of America

1-866-232-8484 (toll free)

info@alzfdn.org

http://www.alzfdn.org

Medications to treat Alzheimer’s Disease:

This brief summary does not include all information important for patient use and should not be used as a substitute for professional medical advice. Consult the prescribing doctor and read the package insert before using these or any other medications or supplements.

Drug Name: Aricept (donepezil)

Drug Type and Use: Cholinesterase inhibitor prescribed to treat symptoms of mild, moderate and severe Alzheimer’s.

How it works: Prevents the breakdown of acetylcholine in the brain.

Common Side Effects: Nausea, vomiting, diarrhea, muscle cramps, fatigue and weight loss.

Manufacture’s Recommended Dosage:

*Tablet: Initial dose of 5 mg once a day

*May increase dose to 10mg/day after 4-6 weeks if well tolerated, then to 23 mg/day after at least 3 months.

*Orally disintegrating tablet: Some dosage as above.

*23mg dose available as brand name tablet only.

For More information: For current information about this drugs’s safety and use , visit http://www.aricept.com/prescribing-and-patient-info.

Drug Name: Exelon (rivastigmine)

Drug Type and Use: Chonlinesterase inhibitor prescribed to treat symptoms of mild to moderate Alzheimer’s (patch is also for severe Alzheimer’s).

How it works: Prevents the breakdown of acetylcholine (a brain chemical similar to acetylcholine) in the brain.

Common Side Effects: Nausea, vomiting, diarrhea, weight loss, indigestion and muscle weakness.

Manufacturer’s Recommendation Dosage:

*Capsule: Initial dose of 3mg/day (1.5 mg twice a day)

*May increase dose to 6mg/day (3mg twice a day), 9mg (4.5 mg twice a day) and 12mg (6mg twice a day) at minimum 2 week intervals if well tolerated.

*Patch: Initial dose of 4.6 mg once a day; may increase dose to 9.5 mg once a day and 13.3 mg once a day at minimum 4 week intervals if well tolerated.

For More Information: For current information about this drug’s safety and use, visit http://www.fda.gov/Drugs. Click on “Drugs@FDA”, search for Exelon and click on drug name links to see “Label Information”.

Drug Name: Namenda (memantine)

Drug Type & Use: N-methyl D-aspartate (NMDA) antagonist prescribed to treat symptoms of moderate to severe Alzheimer’s.

How it Works: Blocks the toxic effects associated with excess glutamate and regulates glutamate activation.

Common Side Effects: Dizziness, headache, diarrhea, constipation and confusion.

Manufacturer’s Recommended Dosage:

*Tablet: Initial dose of 5 mg once a day.

*May increase dose to 10 mg/day (5mg twice a day), 15 mg/day (5mg and 10mg as separate doses) and 20 mg/day (10mg twice a day) at minimum 1 week intervals if well tolerated.

*Oral solution: Same dosage as above.

*Extended-release capsule: Initial dose of 7mg once a day; may increase dose to 14mg/day, 21mg/day and 28 mg/day at minimum 1 week interval if well tolerated.

For more information: For current information about this drug’s safety and use, visit http://www.namendaxr.com. Click on “Full Prescribing Information” to see the drug label.

Drug Name: Namazaric (memantine extended-release and donepezil)

Drug Type and Use: NMDA antagonist and cholinesterase inhibitor prescribed to treat symptoms of moderate to severe Alzheimer’s.

How it works:  Blocks the toxic effects associated with excess glutamate and prevents the breakdown of acetylcholine in the brain.

Common Side Effects: Headache, nausea, vomiting, diarrhea and dizziness.

Manufacturer’s Recommended Dosage:

*Capsule: 28mg memantine extended release+10mg donepezil once a day.

*14mg memantine extended release+10mg donepezil once a day (for patients with severe renal impairment).

For more information: For current information about this drug’s safety and use, visit http://www.namzaric.com. Click on “Full Prescribing Information” to see the drug label.

Drug Name: Razadyne (galantamine)

Drug Type and Use: Cloninesterase inhibitor prescribed to treat symptoms of mild to moderate Alzheimer’s.

How it works: Prevents the breakdown of acetycholine and stimulates nicotinic receptors to release more acetylcholine and stimulates nicotinic receptors to release more acetylcholine in the brain.

Common Side Effects: Nausea, vomiting, diarrhea, decreased appetite, dizziness headache.

Manufacturer’s Recommended Dosage:

*Tablet: Initial dose of 8mg/day (4mg twice a day)

*May increase dose to 16mg/day (8mg twice a day) and 24mg/day (12mg twice a day) at minimum 4 week intervals if well tolerated.

*Extended release capsule: Same dosage as above but taken once a day.

For more information: For current information about this drug’s safety and use, visit http://www.janssendmd.com/pdf.razadyne/PI-Razadyne-RazadyneER.pdf to see the drug label.

*Available as a generic drug.

Disclaimer: this information was taken from the National Institute on Aging: Alzheimer’s Disease Education and Referral Center pamphlet. This information it totally subjected and offered as information only. Please check with your doctor for further information. Contact the above numbers and emails for more information.