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Acetylcholinesterase Inhibitor

Galantamine

Brand names: Reminyl, Reminyl XL

Used in: Delirium & Cognitive Impairment

Galantamine is a cholinesterase inhibitor used for mild-to-moderate Alzheimer's disease.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Recommended starting dosage is 8 mg/day in morning; increase to initial maintenance dose of 16 mg/day after a minimum of 4 weeks. Based on clinical benefit and tolerability, dosage may be increased to 24 mg/day after a minimum of 4 weeks at 16 mg/day. ( 2.1 ) Take with food; ensure adequate fluid intake during treatment ( 2.1 ) Hepatic impairment: should not exceed 16 mg/day for moderate hepatic impairment; do not use in patients with severe hepatic impairment ( 2.2 ) Renal impairment: should not exceed 16 mg/day for creatinine clearance 9 to 59 mL/min; do not use in patients with creatinine clearance less than 9 mL/min. ( 2.3 ) Conversion from galantamine tablets to galantamine …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-09-12. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It inhibits acetylcholinesterase and also modulates nicotinic receptors, increasing cholinergic transmission to support cognition; it eases symptoms rather than altering the disease.

Prescribing in practice

  • Cholinergic effects (nausea, vomiting, weight loss, bradycardia) occur — titrate slowly; serious skin reactions are rare but reported.
  • Use caution in cardiac conduction problems, active peptic ulcer disease and significant airways disease.
  • Reduce the dose in renal or hepatic impairment.

Monitoring

Review cognition and function, heart rate, weight and gastrointestinal tolerance.

Counselling the patient

  • Nausea or appetite loss can occur, especially when increasing the dose.
  • Report fainting, a slow pulse, significant weight loss, or any severe rash.

Evidence & guidelines

Recommended for mild-to-moderate Alzheimer's disease per NICE NG97/TA217.

Reference: NICE TA217; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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