Galantamine: Price, Dosage & Where to Buy

Galantamine is a cholinesterase inhibitor used to treat mild to moderate dementia associated with Alzheimer's disease. It is a medicine that requires a prescription in the United Kingdom and is available as film-coated tablets, extended-release capsules and an oral solution. Treatment benefit and tolerability are assessed when the prescribed dosage is reviewed.

Galantamine tablets are indicated for mild to moderate dementia of the Alzheimer's type. This means the labelled use is for dementia associated with Alzheimer's disease within this severity range.

Mild cognitive impairment is distinct from this indication: people with mild cognitive impairment have isolated memory impairment greater than expected for their age and education, but do not meet diagnostic criteria for Alzheimer's disease. The label reports that the beneficial effects of galantamine tablets are lost when treatment is discontinued.

Galantamine belongs to a class of medicines called cholinesterase inhibitors. These medicines reduce the breakdown of acetylcholine, a chemical messenger that helps nerve cells communicate.

By allowing this messenger to remain available for longer, they support signalling between nerve cells involved in memory and thinking. Their effects are not restricted to the brain: increased acetylcholine activity can also affect the heart, digestive system and other parts of the body.

The label lists film-coated tablets of 4 mg, 8 mg and 12 mg, extended-release capsules of 8 mg, 16 mg and 24 mg, and oral solution of 4 mg/mL. The usual starting dose is 4 mg twice daily for immediate-release tablets. The label lists an initial maintenance dosage of 8 mg twice daily after a minimum of 4 weeks.

The label lists a possible further increase to 12 mg twice daily after a minimum of 4 weeks at 8 mg twice daily, based on clinical benefit and tolerability. The label lists a recommended tablet dosage range of 16 to 24 mg/day, given twice daily. Tablet administration is described with food, preferably morning and evening meals, with adequate fluid intake during treatment.

The label lists a maximum of 16 mg/day for moderate hepatic impairment or creatinine clearance of 9 to 59 mL/min. Use is not recommended in severe hepatic impairment or when creatinine clearance is less than 9 mL/min.

A missed dose should not be compensated for by doubling the next dose. A pharmacist can advise on returning to the prescribed schedule. If treatment has been interrupted for more than three days, the label describes restarting at the lowest dosage and gradually increasing again; contact the prescriber before restarting after such an interruption.

There are no adequate data on developmental risk from galantamine use in pregnant women. Animal studies showed developmental toxicity, including abnormalities and reduced offspring growth, and the label warns of possible fetal harm.

There are no data on galantamine in human milk, effects on breastfed infants or effects on milk production. Breastfeeding benefits should be considered alongside the mother's clinical need and potential adverse effects on the infant.

The tablet label specifies storage at 20° to 25°C, with excursions permitted to 15° to 30°C. Keep the medicine out of reach of children and follow the storage directions on the pack.