memantine / donepezil ER
Namzaric (memantine / donepezil ER) is a combination medication used to treat moderate-to-severe dementia in people with Alzheimer's disease. It contains memantine (an NMDA antagonist) and donepezil (an acetylcholinesterase inhibitor). It's only for people who are already taking 10 mg of donepezil daily, and it doesn't have generic versions available as of Fall 2024. The usual dosage is to take one capsule by mouth once daily in the evening. Some potential side effects include dizziness and diarrhea.
What is Namzaric (memantine / donepezil ER)?
What is Namzaric (memantine / donepezil ER) used for?
Moderate-to-severe dementia in adults with Alzheimer's disease (AD)
How Namzaric (memantine / donepezil ER) works
Namzaric (memantine / donepezil ER) is a combination of two medications that work together to treat Alzheimer's disease (AD):
Memantine is an NMDA antagonist. It blocks glutamate, a chemical in the brain that's believed to be overactive in people with AD. This might improve certain symptoms like memory and attention.
Donepezil is an acetylcholinesterase inhibitor. It raises the levels of acetylcholine in the brain, a chemical important for learning and memory.
Drug Facts
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What are the side effects of Namzaric (memantine / donepezil ER)?
Common Side Effects
- Headache
- Diarrhea
- Nausea
- Vomiting
- Dizziness
- Loss of appetite
- Bruising
Other Side Effects
- Constipation
- Weight gain
- Back pain
- Sleepiness
- Depression
- Blood pressure changes
- Nervousness
- Hallucinations
- Trouble sleeping
- Aggressive behavior
- Eczema
Serious Side Effects
- Heart-related problems: slow heartbeat, fainting
- Stomach ulcers and bleeding: upset stomach, heartburn, indigestion, blood in the stool
- Seizure
- Worsening of lung problems: trouble breathing, wheezing
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Peptic ulcer—burning stomach pain, loss of appetite, bloating, burping, heartburn, nausea, vomiting
- Seizures
- Slow heartbeat—dizziness, feeling faint or lightheaded, confusion, trouble breathing, unusual weakness or fatigue
- Stomach bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds
- Trouble passing urine
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Namzaric (memantine / donepezil ER)
Pros
Conveniently combines two medications in one capsule
Only taken once a day
Capsules can be opened and sprinkled on applesauce
Can be taken with or without food
Cons
Can cause dizziness and drowsiness
Doesn't cure Alzheimer's disease
Can take weeks to months for symptom improvement
Interacts with many medications
Pharmacist tips for Namzaric (memantine / donepezil ER)
Take Namzaric (memantine / donepezil ER) in the evening with or without food. Taking it close to your bedtime will allow you to sleep through some of the side effects like dizziness and drowsiness.
If you have trouble swallowing the Namzaric (memantine / donepezil ER) capsule whole, you can open it and sprinkle the contents onto applesauce. Swallow the mixture without chewing. Don't try to chew or crush the capsules because that can affect how the medication works.
If you wake up in the morning and realize that you forgot your Namzaric (memantine / donepezil ER) dose last night, just skip it and wait to take your next dose at your regularly scheduled time. Doubling up to make up for missed doses can lead to serious side effects.
It can take weeks to months after you start Namzaric (memantine / donepezil ER) before you see a noticeable improvement in your symptoms. Speak with your prescriber if you have questions about when you should start to feel better.
Don't stop taking Namzaric (memantine / donepezil ER) unless your prescriber has told you to do so. Doing so can cause withdrawal symptoms like unusual mood and behavior changes.
Namzaric (memantine / donepezil ER) can cause your stomach to make more acid, which can worsen certain conditions like peptic ulcer disease or stomach bleeding. Also, check with your prescriber before taking NSAIDs like ibuprofen (Advil, Motrin) because doing so can raise your risk of stomach ulcers and bleeds.
Frequently asked questions about Namzaric (memantine / donepezil ER)
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What are the risks and warnings for Namzaric (memantine / donepezil ER)?
Namzaric (memantine / donepezil ER) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Slowed heartbeat
Namzaric (memantine / donepezil ER) can slow down your heartbeat. In some cases, this can lead to fainting. Let your prescriber know if you have any falls or start to feel lightheaded.
Stomach ulcers and bleeding
Risk factors: Taking NSAIDs | History of stomach ulcers or bleeds
Namzaric (memantine / donepezil ER) can raise the amount of stomach acid your body makes, which can put you at risk for stomach ulcers and bleeding. NSAIDs and many over-the-counter cold and pain medications can also raise your risk of stomach bleeds, so you might want to avoid taking these medications at the same time. Talk to your prescriber if you have a worsening upset stomach, heartburn, indigestion, or blood in the stool.
Nausea and vomiting
Nausea, vomiting, and diarrhea are common side effects of Namzaric (memantine / donepezil ER). These side effects are usually mild and tend to go away on their own within 1 to 3 weeks. Let your care team know if these symptoms become bothersome or prevent you from taking your medication daily.
Urination problems
Namzaric (memantine / donepezil ER) can cause problems with urination by blocking the flow from your bladder. Let your prescriber know if you notice any changes in your urination, such as difficulty or pain while urinating.
Seizures
Risk factors: Alzheimer's disease
Namzaric (memantine / donepezil ER) might cause seizures. But seizures are often linked to Alzheimer's disease itself. Speak with your prescriber if you experience seizures while taking this medication.
Worsening lung conditions
Risk factors: Asthma | COPD
Namzaric (memantine / donepezil ER) should be used carefully in people with lung conditions like asthma or chronic obstructive pulmonary disease (COPD). That's because the donepezil in it increases a chemical called acetylcholine, which can make airways narrower. This can make it harder to breathe and potentially worsen these conditions. Let your prescriber know if you have a history of breathing problems to make sure it's safe for you.
Namzaric (memantine / donepezil ER) dosage forms
Typical dosing for Namzaric (memantine / donepezil ER)
If your condition is stable with donepezil only: The typical starting dose is 7 mg/10 mg (memantine/donepezil) by mouth once per day in the evening. Your prescriber will gradually raise your dose until you reach the maximum dose of 28 mg/10 mg (memantine/donepezil) once per day.
If your condition is stable with both donepezil and memantine (separately): The typical starting dose is 28 mg/10 mg (memantine/donepezil) by mouth once per day in the evening.
Your dose might differ if you have kidney problems.
How much does Namzaric (memantine / donepezil ER) cost?
Namzaric (memantine / donepezil ER) contraindications
Allergy to piperidine medications (e.g., trihexyphenidyl)
What are alternatives to Namzaric (memantine / donepezil ER)?
Moderate-to-severe dementia in adults with Alzheimer's disease (AD)
Dementia related to Alzheimer's disease or Parkinson's disease
What is the latest news about Namzaric (memantine / donepezil ER)?
Namzaric (memantine / donepezil ER) images
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References
Best studies we foundAllergan, Inc. (2024). Namzaric- memantine hydrochloride and donepezil hydrochloride capsule; Namzaric- memantine hydrochloride and donepezil hydrochloride kit [package insert]. DailyMed.
BioSpace. (2016). Allergan and Adamas Pharmaceuticals announce settlement with Amneal related to NAMZARIC patent litigation. PRNewswire.
Birks, J. S., et al. (2018). Donepezil for dementia due to Alzheimer's disease. The Cochrane Database of Systematic Reviews.
DrugBank Online. (n.d.). Piperidines.
InformedHealth.org. (2022). Alheimer’s disease: Research summaries – Does memantine help? Institute for Quality and Efficiency in Health Care.
Kumar, A., et al. (2023). Donepezil. StatPearls.
Pandis, D., et al. (2012). Seizures in Alzheimer disease: Clinical and epidemiological data. Epilepsy Currents.
Reeve, E., et al. (2019). Deprescribing cholinesterase inhibitors and memantine in dementia: Guideline summary. The Medical Journal of Australia.
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