Drug interactions - summary-

Cimetidine + galatamine-
cimetidine increased  bioavailability of galatamine

CYP2D6 or CYP3A4 inhibitors + Galatamine -
drugs that are potential ihibitors of CYP2D6 or CYP3A4  may icrease AUC of galatamine

Erythromycin + galatamine-
erythromycin increased AUC of galatamine

Ketoconazole + galatamine-
 Ketoconazole increased AUC of galatamine

Paroxetine + galatamine-
paroxetidine increased oral bioavailability of galaamine

Galatamine + anticholinergics -
galamine has the potential  to intefere with activity of anticholinergic medications

Galatamine + neuromuscular blocking agents -
galatamine may exaggerate the neuromuscular blockade effects of neuromuscular
blocking agents during anesthesia

Galatamine + NSAIDs-
galatmine may increase gastric secretion because of inceased cholinergic activity.
Monitor patients for  symptoms of active or ocult GI bleeding

Galatamine + succinyl cholinergic agonists( eg bethanectol) other cholinersterase inhibitors/
Succinyl cholinergic agonists( eg bethanectol) other cholinersterase inhibitors + Galatamine-
a synergic effect is expected when combined

Alzheimers disease

Most serious adverse drug reactions -

CNS -  depression  6% dizziness  8%    headache  7%      insomnia 4%
            somnolence  3%     tremor   3%

GI -      abdominal pain  4%    anorexia 8%   diarrhea  8%    dyspepsia 4%
            nausea  23%                vomiting 12%

GU -   hematuria    2%         urinarybtract infection  7%

Miscellaneous-   anemia  2%       bradycardia 2%    fatigue 4%    rhinitis 4%
                              syncope 2%      weight decrease  6%

Known hypersensitivity-

Special  precautions-

Anesthesia- galatamine as a cholinesterate inhibitor is likely to exaggreate the neuromuscular
effect of succinyl choline type and similar neuro-muscular blocking agents during anesthesia

Cardiovascular conditions- bradycardia and all types of heasrt block have been reported
with or without underlying cardiac conduction abnormalities. Consider all patients are
at risk of adverse reactions on cardiac conduction.

Pulmonary  conditions- prescribe galatamine with care to patients with a history  of severe
asthma or obstructive pulmonary disease

Renal function impairment - in patients with severe renal function impairment proceed cautiously
with dose totration. Do not exceed a dose of 16mg/day

Hepatic function impairment-  use of galatamine in patients with severe hepatic impairment
is not recommended

Pregnancy- use galatamine during pregnancy only if the potential benefit justifies the potential
risk to the fetus.

Lactation-galatamine has no indication for use in breast feeding  mothers

Children-   use of galactamine in children is not recommended

Monitoring- monitor patients for symptoms of active or occult  GI bleeding especially those
with increased risk of developing ulcerseg history of ulcer disease

Indication-
Alzheimers disease

Dosage-
usual dosage- 16  to 32mg given twice daily. 32mg/ day dose is not as well tolerated
as the lower doses and does not provide increased efficacy
Possible that a daily dose of 24mg/ day  might provide benefits insome persons

Administer galantamine twice daily  preferably with morning and evening meals

1. Administer galatamine ER capsules once daily in the morning preferably with food.

2. Advice patents that most frequent adverse drug reactions can be be minimized by
following the recommended dosage and administration.

Administer galantamine  preferably with morning and evening meals

Pregnancy-
Use galatamine during pregnancy only if the potential benefit justifies the potential
risk to the fetus.

Lactation-
Galatamine has no indication for use in breast feeding  mothers

Children-  
Use of galactamine in children is not recommended