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NMDA receptor antagonist

Memantine hydrochloride

Brand names: Ebixa

Adult dose

Dose: 5mg OD initially, increase weekly by 5mg to 20mg OD
Route: PO
Frequency: OD

Dose adjustments

Renal

Reduce in moderate-severe renal impairment per BNF

Clinical pearls

  • Moderate-severe Alzheimer's disease, monotherapy or with cholinesterase inhibitor (NICE TA217)

Contraindications

  • Severe renal impairment
  • Concurrent NMDA antagonists (amantadine/ketamine)

Side effects

  • Headache
  • Dizziness
  • Constipation
  • Hypertension
  • Hallucinations (rare)

Interactions

  • Amantadine/ketamine
  • Levodopa
  • Hydrochlorothiazide (raised memantine)

Monitoring

  • MMSE/cognitive assessment

Reference: BNF; NICE TA217/NG97; https://bnf.nice.org.uk/drugs/memantine-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.