alzheimers drugs

adacanumab generic

aduhelm brand

lecanemab generic

leqembi brand

donepezil formulations

ODT, tablet, patch

donepezil ODT/tablet generic

Aricept brand

donepezil oral dosing

start 5mg qhs; increase to 10mg after 4-6 weeks

Moderate-severe diseas; may increase to 23mg qhs after at least 3 mo of 10mg qhs

donepezil patch generic

adlarity brand

donepezil + memantine generic

namzaric brand

adlarity dosing

5mg/24hrs once WEEKLy; increase to 10mg/24 hrs once WEEKy after 4-6 weeks

rivastigmine generic

exelon brand

rivastigmine formulations

capsule, patch

rivastigmine capsule dosing

1.5mg bid; can increase every 2 weeks to max 6mg BID WITH FOOD

rivastigmine patch dosing

4.6mg/24hrs once DAILY; increase every 4 weeks to max 13.3mg/24hrs once DAILY (max 4.6mg/24hrs in hepatic impairment)

galantamine formulation

tablet, ER capsule, solution

galantamine IR tab/solution dosign

4mg BID ;can increase every 4 weeks to max 12mg bid WITH FOOD

galantamine er capsule dosing

8mg daily, can increase every 4 weeks to max 24mg daily WITH FOOD

Acetylchoninesterase inhibitors warnings

cardiac effects, bradycardia, AV block, syncope. GI effects (N/V/D, weight loss, anorexia; increase risk with bw <55kg) skin reactions

skin reaction rivastigmine

allergic contact dermatitis

skin reaction galantamine

SJS

Donepezil additional warning

QTc prolongation

Acetylchoninesterase inhibitors side effects

insomnia, dizziness

Acetylchoninesterase inhibitors notes

slower titrate (every 6 weeks) may mitigate GI effects; but if treatment is interupted more than 3 days, must restart from initation dose

Why is donepezil QHS

Nausea; can be moved to morning if insomnia occurs

Adlarity patch notes

store in fridge; remove patch and allow to come to room temperature prior to admin (but apply within 24 hrs of fridge removal); if transitioning from PO, apply at same time as last oral dose

Exelon patch notes

remove prior to MRI; if transitioning from PO, apply patchy the day after the last oral dose

Memantine generic

namenda

memenatine formulations

tablet, capsule, oral solution

memantine IR dosing

5mg po dialy, titrate weekly to 10mg po bid (max 5mg po BID in crcl<30)

memantine ER dosing

start 7mg po daily, titrate weekly to 28mg po daily (max 14 mg po daily CrCL <30)

Switch from memantine ir to er

IR 10mg BID to ER 28 mg daily; begin er the day after last IR dose

Memantine warnings

caution with drugs that increase urin ph (decreases memantine clearance) ie sodium bicarb, acetaxolamide or severe urinary tract infections

memantine side effects

generally well tolerated; dizziness, confusion, headache, constipation

memenatine counseling

ER capsule/namzuric; do not crush or chew. Capsules can be open and sprinkled on applesauce/taken immediately