In the article, we will consider the instructions and reviews for Memantine Canon. This is a medication intended for the treatment of dementia of the Alzheimer's type of severe and moderate degree. The manufacturer of this medical product is the Russian pharmaceutical company Canonpharma Production CJSC.
Composition and release form
The dosage form of this medication is film-coated tablets: round, biconvex, white, at a dosage of 5, 15 and 20 mg. Or blue, at a dosage of 10 mg. The drug is packaged in blister packs made of PVC film and printed aluminum lacquered foil.
The tablets contain the active element of the drug - memantine hydrochloride, as well as additional substances: colloidal silicon dioxide, lactose monohydrate, povidone, calcium hydrogen phosphate dihydrate, croscarmellose sodium, magnesium stearate. The composition of the film shell includes: hyprolose, titanium dioxide, hydroxypropyl methylcellulose, talc, black iron oxide.
Pharmacological properties
The active component of the drug from CJSC "Canonpharma Production" - memantine - is a non-competitive potential-dependent blocker of NMDA receptors with moderate affinity. This substance completely blocks the effects of glutamate, which is capable of provoking the development of neuronal dysfunction in pathologically high concentrations.
The main characteristic of the active substance of Memantine Canon is that this adamantane derivative is similar in pharmacological properties and chemical structure to amantadine. It blocks NMDA-glutamate receptors (including in the substantia nigra), thereby reducing the excessive stimulatory effect of glutamate cortical neurons on the neostratum, which develops against the background of insufficient dopamine production. To date, there is no information reliably proving the ability of this drug to prevent or slow the progression of pathological symptoms in Alzheimer's disease.
NMDA-glutamate receptor antagonists have a symptomatic nootropic effect, and, according to experimental data, they act as neuroprotectors in vascular and mixed dementia. Their mechanism is based on the reduction of glutamate neurotoxicity. Excessive activity of the glutamatergic system is observed both in the neurodegenerative process and in cerebral ischemia. Drugs may be effective in advanced Alzheimer's disease.
Indications for the use of the medication
According to the instructions for use for Memantine Canon,this pharmacological product is used in the treatment of dementia of the Alzheimer's type with severe and moderate intensity. In some cases, medication is not prescribed. More on that later.
Contraindications for prescribing
Absolute contraindications to the use of Memantin Canon are:
- severe liver failure (Child-Pugh grade C);
- lactose deficiency or malabsorption of glucose or galactose, congenital galactose intolerance;
- pregnancy, lactation;
- under 18;
- high sensitivity to the active or additional elements of the drug.
There are also some relative contraindications for taking the medication, in the presence of which the medicine should be taken with caution:
- convulsive syndrome, epilepsy (history);
- chronic heart failure;
- arterial hypertension (uncontrolled);
- myocardial infarction (in the past);
- impaired liver or kidney function;
- factors that increase urine pH, such as high intake of gastric alkaline buffers, dietary changes, tubular renal acidosis, or urinary tract infections;
- co-administration with NMDA receptor antagonists (amantadine, ketamine, dextromethorphan).
Instructions for use
Treatment with the drug "Memantine Canon" from the manufacturer "Canonpharma Production" should be carried out under controla specialist with experience in the treatment and diagnosis of dementia in people with Alzheimer's disease. It is recommended to start taking this medication only when the patient (or the person caring for him) is ready to systematically monitor his intake. In addition, it is necessary to continuously evaluate the tolerability of the drug and the effectiveness of the prescribed dosage, preferably within 3 months after the start of therapy.
What else does the instructions for use for "Memantine Canon" tell us? It is required to systematically assess the clinical efficacy of a medical product and the tolerability of therapy in accordance with all existing clinical guidelines. The duration of maintenance treatment is not limited in time, subject to the normal tolerance of the medication and taking into account the positive effect obtained when taking it. In the absence of the latter, or if the patient is intolerant to this treatment, the intake of Memantine Canon tablets must be interrupted.
The medicine is taken orally, at the same time, 1 tablet per day. They are not chewed, washed down with liquid. Eating does not affect the effect of the drug. Maximum per day, you can take no more than 20 mg of the main element of the drug. The specialist sets the dosing regimen individually. At the beginning of therapy, it is recommended to prescribe the minimum effective dose. To reduce the likelihood of unwanted adverse reactions, a constant dosage is selected by titration with an increase of 5 mg once a week (for 3 weeks).
Side effects
According to Memantine Canon reviews, the drug's overall negative adverse reaction profile includes:
- Mental disorders: hallucinations, confusion, psychotic reactions.
- Heart and blood vessels: increased blood pressure, thromboembolism or venous thrombosis, heart defects, heart failure.
- CNS: balance disturbance, dizziness, drowsiness, headache, change in gait, convulsions, epileptic seizures.
- Respiratory system, mediastinal and chest organs: shortness of breath.
- Subcutaneous tissues and skin: Stevens-Johnson syndrome.
- Immune system: increased sensitivity to the constituent elements of the drug.
- Digestive system: constipation, dyspeptic disorders, pancreatitis.
- Biliary tract and liver: impaired liver function tests, hepatitis.
- Urinary tract and kidneys: acute failure.
- Infections and parasitic diseases: fungal infection of the skin and mucous membranes.
- Hematopoietic organs: leukopenia (including neutropenia), agranulocytosis, thrombocytopenic purpura, thrombocytopenia, pancytopenia.
- General disorders: fatigue, general weakness.
In patients suffering from Alzheimer's disease, while taking this pharmacological drug, depressive states, suicidal thoughts, and attempts to commit it were also recorded.
Special Recommendations
Sick,those with a predisposition to epilepsy or suffering from this pathology, as well as patients with a history of seizures, are advised to exercise caution during treatment with Memantine Canon. Since the simultaneous use of the drug with other NMDA receptor antagonists (amantadine, ketamine, dextromethorphan) may cause adverse reactions more often, and they may have a pronounced intensity (mainly at the level of the central nervous system), it is recommended to avoid their combined use.
Careful monitoring of the patient's condition is necessary if he has factors that affect the increase in urine pH: abrupt changes in nutrition (transition to a vegetarian diet, intensive use of gastric alkaline buffers); severe infectious diseases of the urinary tract; tubular renal acidosis.
Memantine Canon therapy in patients with problems of the cardiovascular system should be carried out under the supervision of a cardiologist. In Alzheimer's disease at the stage of severe or moderate dementia, impairments in the ability to control complex mechanisms and transport are often observed. In addition, the use of the Memantine Canon medical product can directly affect the speed of the reaction. In this regard, this category of patients should refrain from such activities.
Use during pregnancy and lactation
Since there are no clinical data on the effect of this drug on the course of pregnancy, it is contraindicated to use Memantine Canon during the period under consideration. In the course of scientific research, it was found thatthe active element of the drug may provoke intrauterine growth retardation when exposed to similar or superior concentrations (experiments were conducted on animals).
There is no information on the excretion of the active substance in breast milk. However, experts suggest that due to its lipophilic structure, memantine can penetrate into breast milk, so taking the drug during the lactation process is contraindicated.
Drug Interactions
When taking Memantine Canon together with other drugs, the following drug interactions may occur:
- M-anticholinergics, levodopa, dopamine receptor agonists: the effect of these substances may be enhanced, as well as when taken with other NMDA receptor antagonists.
- Antipsychotics and barbiturates: there is a decrease in their effect.
- Anticonvulsant medicinal substances (baclofen, dantrolene): influence on their effectiveness - strengthening or weakening of the therapeutic effect.
- Amantadine, ketamine, dextromethorphan: increased likelihood of developing psychosis and depression.
- Phenytoin: concomitant use not recommended.
- Cimetidine, ranitidine, quinidine, procainamide, quinine, nicotine: their plasma concentration may increase, these elements use the same renal cation transport system as memantine.
- Indirect anticoagulants (warfarin): possible increase in MHO.
- Hydrochlorothiazide (or any combination with hydrochlorothiazide): possible decrease in blood levels of hydrochlorothiazide. Although a causal relationship has not been established, monitoring of INR and prothrombin time is recommended in patients taking this medication in combination with warfarin.
- Monoamine oxidase inhibitors, antidepressants and serotonin reuptake inhibitors: Careful monitoring of the patient is required.
What is the difference between "Memantine" and "Memantine Canon"?
Both drugs are highly effective in the treatment of Alzheimer's disease, as well as in the occurrence of varying degrees of severity. These drugs are used as part of complex treatment and have an absolutely identical composition and form of release. Their main differences are that the drugs are produced by different pharmaceutical companies and sold at different prices. The drug "Memantine" is cheaper than "Mementine Canon", so doctors often prescribe this option. The medicine costs about 400 rubles.
Analogues
The list of the main analogues of "Memantine Canon" includes the following medicines:
- "Alzeim" is an absolute analogue of the drug in question with an identical composition. This tool is produced in Argentina.
- Maruksa is a Russian analogue of Memantine Canon based on memantine, but almost twice as expensive.
- "Noodzheron" - a drug produced in Croatia, with memantine in the main composition. Is anabsolute analogue of the drug "Memantine Canon". Despite this, it is a very expensive drug - its cost fluctuates around 2500 rubles.
The doctor should select a replacement.
Reviews
There are quite a lot of positive reviews about Memantine Canon on medical sites and forums dedicated to the discussion of medicines. It is better to familiarize yourself with them in advance. Experts call "Memantine Canon" for Alzheimer's disease the best medicine. They also indicate that the independent use of this remedy is out of the question, since it is a rather serious pharmacological product that can cause a lot of adverse reactions, most of which affect the structures of the nervous system. At the same time, various mental disorders, up to hallucinations and severe depressive states, become the most common side symptom of drug treatment. In this regard, doctors do not recommend self-medication and purchase this drug without a prescription from a specialist.
Patients who were treated with Memantine Canon or its analogues note that the positive effect of therapy is not immediately observed. If the treatment did not provoke negative symptoms, then the result from taking the drug can be seen only after about a month of therapy.
As for the side effects of this medication, patients in the reviews write that negative reactions of the body develop from it in almost every case. The most harmless of them were dyspepticdisorders that resolved in most cases without symptomatic treatment. More serious manifestations of side effects were a violation of the heart, pressure levels, changes in consciousness, severe dizziness. Reviews of Memantine Canon confirm this.
