Donepezil and Memantine

Donepezil/memantine is a prescription medication used to treat dementia in people with Alzheimer's disease. It is a combination medication comprised of a NMDA receptor antagonist (memantine), and an acetylcholinesterase inhibitor (donepezil).

Donepezil/memantine improves mental function by decreasing abnormal activity in the brain and by increasing the amount of a certain naturally occurring substance in the brain.

Donepezil/memantine comes as a capsule to be taken by mouth, once daily. The capsules can be opened to allow the contents to be sprinkled on food for patients who have difficulty swallowing.

Common side effects include headache, diarrhea and dizziness.

Donepezil/memantine is a prescription medication approved for the treatment of moderate to severe dementia of the Alzheimer's type in patients stabilized on memantine and donepezil.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Donepezil and Memantine may be found in some form under the following brand names:

• Namzaric

Serious side effects have been reported with this medications. See the “donepezil/memantine Precautions” section.

Common side effects include the following:

• headache
• diarrhea
• not wanting to eat
• bruising
• dizziness

This is not a complete list of side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• amantadine
• ketamine
• dextromethorphan
• medications that make the urine alkaline
• ketoconazole
• quinidine
• phenytoin
• carbamazepine
• dexamethasone
• rifampin
• phenobarbital

This is not a complete list of drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with this medication including the following: 

• muscle problems if you need anesthesia
• slow heartbeat and fainting. This happens more often in people with heart problems. Call the doctor right away if the patient faints while taking Namzaric.
• more stomach acid. This raises the chance of ulcers and bleeding especially when taking Namzaric. The risk is higher for patients who had ulcers, or take aspirin or other medications to treat inflammation. 
• nausea and vomiting
• difficulty passing urine
• seizures
• worsening of lung problems in people with other lung diseases.

This medication can cause dizziness. Do not drive or operate heavy machinery until you know how Namzaric affects you.

Do not take this medication if you are allergic to donepezil, memantine, or to any of its ingredients. 

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of donepezil/memantine, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking this medication, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to donepezil, memantine, or to any of its ingredients.
• have heart problems including an irregular, slow, or fast heartbeat.
• have asthma or lung problems.
• have seizures.
• have stomach ulcers.
• have bladder or kidney problems.
• have liver problems.
• have surgical, dental, or other medical procedures scheduled and anesthesia may be used.
• are pregnant or plan to become pregnant.
• are breastfeeding or plan to breastfeed.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

There are no adequate data on the developmental risk associated with the use of donepezil/memantine in pregnant women. It is not known if this medication can harm an unborn baby. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if donepezil/memantine crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using this medication.

Take donepezil/memantine exactly as prescribed.

This medication comes in an extended-release capsule form and is taken once a day in the evening before going to bed.

Do not change your dose or stop taking this medication without talking to your doctor.

Take donepezil/memantine with or without food.

The capsules may be opened and sprinkled on applesauce before swallowing. Sprinkle all of the medicine in the capsule on the applesauce. Do not divide the dose.

If you do not open and sprinkle capsules on applesauce, the capsules must be swallowed whole. Do not divide, chew, or crush capsules.

If you miss a dose, take donepezil/memantine at your next scheduled dose. Do not take two doses at the same time

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• other medical conditions you have
• other medications you are taking
• your kidney function

The recommended dose of Namzaric (memantine and donepezil hydrochloride) is 28 mg memantine/10 mg donepezil hydrochloride once daily in the evening. 

For those whose kidneys are not working as well as they should be, the recommended dose is 14 mg memantine/10 mg donepezil hydrochloride once daily in the evening

If you take too much of this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if an overdose is suspected, seek emergency medical attention.

• Store this medication at 20°C to 25°C (68°F to 77°F). 
• Keep this and all medicines out of the reach of children.