📋 Indications & Clinical Dosage
*Mild to moderate dementia in Alzheimers disease:*
Adult: Initially 5 mg once daily for one month, thenincreased if necessary up to 10 mg daily, doses to begiven at bedtime. Assess response 2-4 months, after reaching maintenance dose and only continue if positive evidence of benefit. Children: Not recommended.
⚠️ Precautions & Warnings
Hepatic and renal impairment, asthma, chronic obstructive pulmonary disease, sick sinus syndrome, supraventricular conduction abnormalities, susceptibility to peptic ulcers. Diagnosis and treatment must be under supervision of a clinician experienced in Alzheimers dementia, bladder outflow obstruction, seizures, extra-pyramidal symptoms.
🔄 Drug Interactions
Neuromuscular blockers, cholinergics and anti-cholinergic agents, anaesthetics, beta-blockers, P450 enzyme inducers or inhibitors.
⚠️ Adverse Reactions / Side Effects
Bradycardia, duodenal ulcers, gastric ulcers,
GI haemorrhage. Abnormal dreams, aggression, agitation, anorexia,diarrhoea,dizziness,fatigue,hallucinations,headache,insomnia,muscle cramps, nausea, pruritus, rash, syncope, urinary incontinence, vomiting, seizures. Rare: AV block, extrapyramidal symptoms, hepatitis, potential for bladder outflow obstruction, sino-atrial block, liver dysfunction (consider withdrawal).