📋 Indications & Clinical Dosage
*Moderate to severe dementia in Alzheimers disease:*
Adult: Initially 5 mg once daily, then increased in steps of 5 mg every week; usual maintenance 20 mg daily; max. 20 mg per day.
Children: Not recommended.
⛔ Contraindications
Severe renal impairment.
⚠️ Precautions & Warnings
Moderate renal, hepatic impairment, epilepsy or predisposition to epilepsy, history of convulsions, recent MI, uncompensated heart failure, uncontrolled hypertension.
🔄 Drug Interactions
Amantadine, ketamine, dextromethorphan, levodopa, dopaminergic agonists, anticholinergics, barbitu-rates, neuroleptics, baclofen, dentrolene, cimetidine, ranitidine, procainamide, quinidine, quinine, nicotine, hydrochlorothiazide.
⚠️ Adverse Reactions / Side Effects
Balance disorders, constipation, dizziness, drowsiness, dyspnea, headache, depression, hypertension, abnormal gait, confusion, fatigue, tiredness, hallucinations, heart failure, thrombosis, vomiting
Rare: Seizures, hepatitis, pancreatitis, psychosis, suicidal ideation Prices:
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Caution advised
Lactation / Breastfeeding:
Caution advised
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.