Administered once daily, taken at the same time every day. Adult 1st wk: 5 mg/day; 2nd wk: 10 mg/day; 3rd wk: 15 mg/day; from 4th wk onwards: 20 mg/day. Max: 20 mg/day. Maintenance: 20 mg/day. Elderly >65 yr 20 mg/day. Patient w/ moderate renal impairment 10 mg/day. May be increased up to 20 mg/day if well-tolerated after at least 7 days of treatment. Patient w/ severe renal impairment 10 mg/day.
Caution is recommended w/ patients suffering from epilepsy. Concomitant use of amantadine, ketamine or dextromethorphan should be avoided. Clinical data are limited on patients w/ MI, uncompensated congestive heart failure or uncontrolled HTN & patients w/ these conditions should be closely supervised. Urinary pH increase may elevate plasma levels of memantine. Not recommended in patients w/ severe hepatic impairment.
Effects of L-dopa, dopaminergic agonists & anticholinergics may be enhanced. Effects of barbiturates, neuroleptics & hydrochlorothiazide may be reduced. Effects of dantrolene & baclofen may be modified. Plasma levels of cimetidine, ranitidine, procainamide, quinidine, quinine & nicotine may be increased.
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