What is galantamine? Galantamine improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning. Galantamine is used to treat mild to moderate Alzheimer's type dementia. Galantamine may also be used for purposes not listed in this medication guide. Warnings Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use. Before taking this medicine You should not use galantamine if you are allergic to it. To make sure galantamine is safe for you, tell your doctor if you have: urination problems; heart disease or a heart rhythm disorder; a history of stomach ulcer or bleeding; seizures or epilepsy; kidney disease; liver disease; or a history of asthma or chronic obstructive pulmonary disease (COPD). It is not known whether galantamine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether galantamine passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding. How should I take galantamine? Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended. The galantamine extended-release capsule is usually taken once per day in the morning. Follow your doctor's instructions. The galantamine short-acting tablet or the oral solution (liquid) are usually given two times per day, with meals. Follow your doctor's instructions. The extended-release capsule works best if you take it with food. Do not crush, chew, break, or open an extended-release capsule. Swallow it whole. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions. Take galantamine with a full glass of water. Drink 6 to 8 full glasses of water each day to keep from getting dehydrated while taking this medication. If you need surgery, tell the surgeon ahead of time that you are using galantamine. You may need to stop using the medicine for a short time. If you have stopped taking galantamine for any reason, talk with your doctor before you start taking it again. You may need to restart the medication at a lower dose. Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze. What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include severe nausea, vomiting, stomach cramps, muscle weakness or spasm, watery eyes, drooling, increased urination or bowel movements, sweating, slow heart rate, feeling light-headed or fainting, and seizure (convulsions). What should I avoid while taking galantamine? This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Galantamine side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Galantamine can cause serious skin reactions. Stop using galantamine and call your doctor at once if you have the first signs of any skin rash, no matter how mild. Call your doctor at once if you have: chest pain, slow heart rate; little or no urinating; blood in your urine; signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin; a light-headed feeling, like you might pass out; or severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Common side effects may include: nausea, vomiting, diarrhea, loss of appetite; headache, dizziness; or weight loss. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   Galantamine dosing information Usual Adult Dose for Alzheimer's Disease: Immediate release tablet and oral solution: Initial dose: 4 mg orally twice a day, preferably with morning and evening meals -After a minimum of four weeks, increase to 8 mg twice a day, then after an additional 4 weeks, may increase to 12 mg twice a day Maintenance dose: 16 to 24 mg per day given in 2 divided doses Maximum dose: 24 mg/day Extended release capsule: Initial dose: 8 mg orally once a day, preferably with the morning meal -After 4 weeks, dose should be increased to 16 mg once a day, a further increase to 24 mg once a day may be considered after a minimum of 4 weeks of taking 16 mg/day Maintenance dose: 16 to 24 mg orally once a day based on clinical benefit and tolerability Maximum dose: 24 mg/day Conversion from Immediate-Release (IR) Tablets or Oral Solution to Extended-Release (ER) Capsules: -Take the last dose of IR formulation n in the evening prior to starting ER capsule; start ER capsule following morning at once a day dosing -Converting from IR to ER should occur at the same total daily dosage Comments: -During clinical trials, an immediate-release dose of 32 mg per day was found to be less well tolerated and did not increase clinical benefit; dosing at 24 mg/day was not found to provide statistically significant increased clinical benefit from 16 mg/day; however, it might provide additional benefit for some patients. -Dose increases should be based upon assessment of clinical benefit and tolerability of the previous dose. -If therapy is interrupted for more than 3 days, the patient should be restarted at the lowest dosage and the dosage escalated to current dose. Use: For the treatment of mild to moderate dementia of the Alzheimer's type.   What other drugs will affect galantamine? Tell your doctor about all your current medicines and any you start or stop using, especially: atropine; cold or allergy medicine that contains an antihistamine (Benadryl and others); medicine to treat Parkinson's disease; medicine to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome; bladder or urinary medicines--darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin; bronchodilators--aclidinium, ipratropium, or tiotropium; This list is not complete. Other drugs may interact with galantamine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

What is galantamine? Galantamine improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning. Galantamine is used to treat mild to moderate Alzheimer's type dementia. Galantamine may also be used for purposes not listed in this medication guide. Warnings Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use. Before taking this medicine You should not use galantamine if you are allergic to it. To make sure galantamine is safe for you, tell your doctor if you have: urination problems; heart disease or a heart rhythm disorder; a history of stomach ulcer or bleeding; seizures or epilepsy; kidney disease; liver disease; or a history of asthma or chronic obstructive pulmonary disease (COPD). It is not known whether galantamine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether galantamine passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding. How should I take galantamine? Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended. The galantamine extended-release capsule is usually taken once per day in the morning. Follow your doctor's instructions. The galantamine short-acting tablet or the oral solution (liquid) are usually given two times per day, with meals. Follow your doctor's instructions. The extended-release capsule works best if you take it with food. Do not crush, chew, break, or open an extended-release capsule. Swallow it whole. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions. Take galantamine with a full glass of water. Drink 6 to 8 full glasses of water each day to keep from getting dehydrated while taking this medication. If you need surgery, tell the surgeon ahead of time that you are using galantamine. You may need to stop using the medicine for a short time. If you have stopped taking galantamine for any reason, talk with your doctor before you start taking it again. You may need to restart the medication at a lower dose. Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze. What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include severe nausea, vomiting, stomach cramps, muscle weakness or spasm, watery eyes, drooling, increased urination or bowel movements, sweating, slow heart rate, feeling light-headed or fainting, and seizure (convulsions). What should I avoid while taking galantamine? This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Galantamine side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Galantamine can cause serious skin reactions. Stop using galantamine and call your doctor at once if you have the first signs of any skin rash, no matter how mild. Call your doctor at once if you have: chest pain, slow heart rate; little or no urinating; blood in your urine; signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin; a light-headed feeling, like you might pass out; or severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Common side effects may include: nausea, vomiting, diarrhea, loss of appetite; headache, dizziness; or weight loss. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Galantamine side effects (more detail) Galantamine dosing information Usual Adult Dose for Alzheimer's Disease: Immediate release tablet and oral solution: Initial dose: 4 mg orally twice a day, preferably with morning and evening meals -After a minimum of four weeks, increase to 8 mg twice a day, then after an additional 4 weeks, may increase to 12 mg twice a day Maintenance dose: 16 to 24 mg per day given in 2 divided doses Maximum dose: 24 mg/day Extended release capsule: Initial dose: 8 mg orally once a day, preferably with the morning meal -After 4 weeks, dose should be increased to 16 mg once a day, a further increase to 24 mg once a day may be considered after a minimum of 4 weeks of taking 16 mg/day Maintenance dose: 16 to 24 mg orally once a day based on clinical benefit and tolerability Maximum dose: 24 mg/day Conversion from Immediate-Release (IR) Tablets or Oral Solution to Extended-Release (ER) Capsules: -Take the last dose of IR formulation n in the evening prior to starting ER capsule; start ER capsule following morning at once a day dosing -Converting from IR to ER should occur at the same total daily dosage Comments: -During clinical trials, an immediate-release dose of 32 mg per day was found to be less well tolerated and did not increase clinical benefit; dosing at 24 mg/day was not found to provide statistically significant increased clinical benefit from 16 mg/day; however, it might provide additional benefit for some patients. -Dose increases should be based upon assessment of clinical benefit and tolerability of the previous dose. -If therapy is interrupted for more than 3 days, the patient should be restarted at the lowest dosage and the dosage escalated to current dose. Use: For the treatment of mild to moderate dementia of the Alzheimer's type. Detailed Galantamine dosage information What other drugs will affect galantamine? Tell your doctor about all your current medicines and any you start or stop using, especially: atropine; cold or allergy medicine that contains an antihistamine (Benadryl and others); medicine to treat Parkinson's disease; medicine to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome; bladder or urinary medicines--darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin; bronchodilators--aclidinium, ipratropium, or tiotropium; This list is not complete. Other drugs may interact with galantamine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

What is rivastigmine? Rivastigmine is used to treat mild to moderate dementia caused by Alzheimer's or Parkinson's disease. Rivastigmine is not a cure for Alzheimer's or Parkinson's disease. Rivastigmine may also be used for purposes not listed in this medication guide. Warnings You should not take oral rivastigmine if you have ever had severe redness, itching, or skin irritation caused by wearing a rivastigmine transdermal skin patch. Before taking this medicine You should not take rivastigmine if you are allergic to rivastigmine or similar medicines, such as felbamate, meprobamate, or carisoprodol. You should not take oral rivastigmine if you have ever had severe redness, itching, or skin irritation caused by wearing a rivastigmine transdermal skin patch. Tell your doctor if you have ever had: an ulcer or stomach bleeding; a seizure; heart problems; liver or kidney disease; urination problems; or asthma, chronic obstructive pulmonary disease (COPD), or other breathing disorder. Tell your doctor if you are pregnant or plan to become pregnant. It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk. How should I take rivastigmine? Do not wear a rivastigmine transdermal skin patch at the same time you are taking rivastigmine capsules or oral liquid. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Take rivastigmine with food. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions. Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). You may swallow the liquid medicine directly from the syringe or mix the medicine with a small glass of water, fruit juice, or soda. Stir and drink this mixture within 4 hours after mixing. Add a little more water to the glass, swirl gently and drink right away. After using the syringe, wipe the outside of it with a clean tissue and put the syringe back into its protective case. Close the medicine bottle using the child-resistant closure. Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking rivastigmine. Rivastigmine doses are based on weight. Your dose needs may change if you gain or lose weight. If you need surgery, tell your surgeon you currently use this medicine. If you stop taking rivastigmine for any reason, do not restart the medicine without talking to your doctor first. You may need to start with a lower dose. Store in an upright position at room temperature, away from moisture and heat. Do not allow the liquid medicine to freeze. What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. If you miss several doses in a row, call your doctor before taking any more of rivastigmine. Get your prescription refilled before you run out of medicine completely. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include severe nausea, vomiting, salivation, sweating, slow heartbeats, weak or shallow breathing, fainting, or seizure (convulsions). What should I avoid while taking rivastigmine? Avoid driving or hazardous activity until you know how rivastigmine will affect you. Your reactions could be impaired. Rivastigmine side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: severe or ongoing vomiting or diarrhea, loss of appetite, weight loss; bloody or tarry stools, cough with bloody mucus or vomit that looks like coffee grounds; a light-headed feeling, like you might pass out; tremors (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck; seizure (convulsions); painful or difficult urination; severe skin redness, itching, or irritation; or dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin. Common side effects may include: upset stomach, nausea, vomiting; loss of appetite; or weakness. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   Rivastigmine dosing information Usual Adult Dose for Alzheimer's Disease: MILD TO MODERATE ALZHEIMER'S DISEASE: ORAL: -Initial dose: 1.5 mg orally twice a day -Maintenance dose: After a minimum of 2 weeks of treatment, if the initial dosage is well tolerated, it can be increased to 3 mg twice a day; subsequent increases to 4.5 mg and 6 mg twice a day should be attempted only after a minimum of 2 weeks at the previous dosage TRANSDERMAL PATCH: -Initial Dose: 4.6 mg/24 hour patch applied to the skin once daily -Maintenance Dose: After a minimum of 4 weeks of treatment at the initial dose, and if well tolerated, the dose can be increased to 9.5 mg/24 hours for as long as this dose is beneficial; the dose can then be increased to 13.3 mg/24 hours -Maximum Dose: 13.3 mg/24 hour patch applied to skin daily; higher doses confer no appreciable additional benefit, and are associated with significant increase in the incidence of adverse events SEVERE ALZHEIMER'S DISEASE: TRANSDERMAL PATCH: -Recommended dose: 13.3 mg/24 hours transdermal patch applied to skin once daily; replace with a new patch every 24 hours Use: For the treatment of mild, moderate, or severe dementia of the Alzheimer's type (AD) Usual Adult Dose for Parkinson's Disease: MILD TO MODERATE PARKINSON'S DISEASE DEMENTIA: ORAL: Initial dose: 1.5 mg orally twice a day with morning and evening meals Maintenance dose: Subsequently, the dose can be increased to 3 mg orally twice a day and further to 4.5 mg twice a day and 6 mg twice a day (based on tolerability) with a minimum of 4 weeks at each dose TRANSDERMAL PATCH: Initial dose: 4.6 mg/24 hours applied to the skin once a day Maintenance dose: After a minimum of four weeks of treatment and if well tolerated, the dose of the patch can be increased to 9.5 mg/24 hours for as long as this dose is beneficial. The dose can then be increased to 13.3 mg/24 hours. Maximum dose: 13.3 mg/24 hours. Higher doses confer no appreciable additional benefit, and are associated with significant increase in the incidence of adverse events. Use: For the treatment of mild to moderate dementia associated with Parkinson's disease   What other drugs will affect rivastigmine? Tell your doctor about all your other medicines, especially: medicine to treat depression, anxiety, mood disorders, or mental illness; cold or allergy medicine (Benadryl and others); beta blocker heart or blood pressure medication; medicine to treat Parkinson's disease; medicine to treat nausea/vomiting, stomach problems, motion sickness, or irritable bowel syndrome; medicine to treat overactive bladder; bronchodilator asthma medication; or an NSAID (nonsteroidal anti-inflammatory drug such as aspirin, ibuprofen, naproxen, Advil, Motrin, Aleve, and others. This list is not complete and many other drugs may affect rivastigmine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.