II. Indication

III. Mechanism

  1. Acetylcholinesterase inhibitor
  2. Acts also at nicotinic receptors
  3. Derived from Daffodil bulbs

IV. Pharmacokinetics

  1. Half-Life: 7 hours in elderly patients
  2. Metabolized by liver enzymes: CYP2D6 and CYP3A4

V. Dosing

  1. Initial: 4 mg PO bid with breakfast and dinner x4 weeks
  2. Maintenance: 8 mg PO bid for at least 4 weeks
  3. Consider 12 mg PO bid if indicated
  4. May require concurrent Antiemetic use

VI. Adverse Effects

  1. No hepatic toxicity found (contrast with Tacrine)
  2. Gastrointestinal effects
    1. Nausea or Vomiting
    2. Diarrhea
    3. Anorexia
    4. Weight loss
  3. Cardiovascular effects
    1. Dizziness
    2. Bradycardia

VII. Efficacy

  1. Moderately preserved cognitive function for >6 months
  2. References
    1. Raskind (2000) Neurology 54:2261 [PubMed]
    2. Tariot (2000) Neurology 54:2269 [PubMed]

VIII. Cost

  1. (2003) Red Book: $134/month

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Cost: Medications

galantamine (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
GALANTAMINE ER 16 MG CAPSULE Generic $1.69 each
GALANTAMINE ER 24 MG CAPSULE Generic $1.94 each
GALANTAMINE ER 8 MG CAPSULE Generic $1.59 each
GALANTAMINE HBR 12 MG TABLET Generic $0.82 each
GALANTAMINE HBR 4 MG TABLET Generic $1.21 each
GALANTAMINE HBR 8 MG TABLET Generic $1.04 each

Ontology: Galantamine (C0016967)

Definition (MSH) A benzazepine derived from norbelladine. It is found in GALANTHUS and other AMARYLLIDACEAE. It is a cholinesterase inhibitor that has been used to reverse the muscular effects of GALLAMINE TRIETHIODIDE and TUBOCURARINE and has been studied as a treatment for ALZHEIMER DISEASE and other central nervous system disorders.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D005702
SnomedCT 323377002, 395727007
English Galantamin, Lycoremine, galanthamine, lycoremine, Galantamine [Chemical/Ingredient], galantamin, GALANTAMINE, galantamine, Galanthamine, 6H-Benzofuro(3a,3,2-ef)(2)benzazepin-6-ol, 4a,5,9,10,11,12-hexahydro-3-methoxy-11-methyl-, Galantamine, Galantamine (product), Galantamine (substance)
Swedish Galantamin
Czech galanthamin, galantamin
Finnish Galantamiini
Japanese リコレミン, ガランタミン, 臭化水素酸ガランタミン, ガランタミン臭化水素酸塩
Polish Niwalina, Galantamina
Spanish galantamina (producto), galantamina (sustancia), galantamina, Galantamina, Licorémina
French Galantamine, Galanthamine
German Galantamin, Galanthamin, Lycoremin
Italian Galantamina
Portuguese Galantamina, Licoremina

Ontology: Razadyne (C0939465)

Definition (MSH) Name of the FDA approved preparation from J&J.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D005702
Czech reminyl
German Reminyl
English Razadyne, Ortho McNeil Neurologics Brand of Galantamine, Ortho-McNeil Neurologics Brand of Galantamine, reminyl, Reminyl
Portuguese Reminyl
Spanish Reminilo