In the article, we consider the instructions and reviews for "Memantine Canon." This is a medication intended for the treatment of severe and moderate Alzheimer's type dementia. The manufacturer of this medication is the Russian pharmaceutical company Canonfarm Production CJSC.
Composition and form of release
The dosage form of this medication is film-coated tablets: round, biconvex, white, at a dosage of 5, 15 and 20 mg. Or blue, at a dosage of 10 mg. The medicine is packaged in blister packs of polyvinyl chloride film and printed aluminum lacquered foil.
The tablets contain the active element of the drug - memantine hydrochloride, as well as additional substances: colloidal silicon dioxide, lactose monohydrate, povidone, calcium hydrogen phosphate dihydrate, croscarmellose sodium, magnesium stearate. The composition of the film membrane includes: hyprolose, titanium dioxide, hydroxypropyl methylcellulose, talc, black iron oxide.
Pharmacological properties
The active component of the drug from Canonfarm Production CJSC - memantine - is a non-competitive potential-dependent blocker of NMDA receptors with moderate affinity. This substance completely blocks the effects of glutamate, which is capable of provoking the development of neuronal dysfunction in a pathologically high concentration.
The main characteristic of the active substance of the drug "Memantine Canon" is that it is a derivative of adamantane in pharmacological properties and chemical structure similar to amantadine. It blocks NMDA-glutamate receptors (including in the substantia nigra), thereby reducing the excessive stimulating effect of glutamate cortical neurons on neostratum, which develops against the background of insufficient dopamine production. To date, information that reliably proves the ability of this medication to prevent or slow the progression of pathological symptoms in Alzheimer's disease is missing.
Antagonists of NMDA receptors for glutamate have a symptomatic nootropic effect, and, according to experimental data, they act as neuroprotectors in vascular and mixed dementia. Their mechanism is based on a decrease in the neurotoxicity of glutamate. Excessive activity of the glutamatergic system is observed both in the neurodegenerative process and in cerebral ischemia. Drugs can be effective in the late stages of Alzheimer's disease.
Indications for the use of the medication
According to the instructions for use with "Memantine Canon", this pharmacological product is used in the treatment of Alzheimer's type dementia in severe and moderate intensity. In some cases, medication is not prescribed. About it further.
Contraindications
Absolute contraindications to the use of Memantin Canon are:
- severe liver failure (on the Child-Pugh scale - class C);
- lactose deficiency or impaired glucose or galactose absorption processes, galactose intolerance of congenital origin;
- pregnancy, lactation;
- age less than 18 years;
- high sensitivity to the existing or additional elements of the drug.
There are also some relative contraindications to taking the medication, in the presence of which the medicine should be taken with caution:
- convulsive syndrome, epilepsy (history);
- chronic heart failure;
- arterial hypertension (uncontrolled);
- myocardial infarction (in the past);
- impaired liver or kidney function;
- factors contributing to an increase in urine pH, for example, heavy intake of gastric alkaline buffers, dietary changes, tubular renal acidosis, or urinary tract infections;
- combined administration with antagonists of NMDA receptors (amantadine, ketamine, dextromethorphan).
Instructions for use
Treatment with Memantine Canon from the manufacturer Canonpharm Production should be supervised by a specialist with experience in the treatment and diagnosis of dementia in people with Alzheimer's disease. It is recommended that you start taking this medication only when the patient (or the person caring for him) is ready to systematically monitor his reception. In addition, it is necessary to constantly evaluate the tolerance of the drug and the effectiveness of the prescribed dosage, preferably within 3 months after the start of therapy.
What else does the application instruction for “Memantine Canon” tell us? It is required to systematically evaluate the clinical efficacy of a medical product and the tolerability of therapy according to all existing clinical recommendations. The duration of maintenance treatment is not limited in time under the condition of normal tolerability of the medication and taking into account the positive effect obtained when taking it. In the absence of the latter, or if the patient is intolerant of this treatment, the administration of Memantine Canon tablets must be interrupted.
The medicine is administered orally, at the same time, 1 tablet per day. They are not chewed, washed down with liquid. Eating does not affect the effect of the drug. Maximum per day, you can take no more than 20 mg of the main element of the drug. The specialist sets the dosage regimen individually. At the beginning of therapy, it is recommended to prescribe the minimum effective dose. To reduce the likelihood of unwanted adverse reactions, a constant dosage is selected by titration with an increase of 5 mg once a week (for 3 weeks).
Side effects
According to reviews of "Memantine Canon", the general profile of negative adverse reactions of the drug includes:
- Mental disorders: hallucinations, confusion, psychotic reactions.
- Heart and blood vessels: increased blood pressure, thromboembolism or venous thrombosis, heart defects, heart failure.
- CNS: imbalance, dizziness, drowsiness, headache, gait changes, cramps, epileptic seizures.
- Respiratory system, mediastinal and chest organs: shortness of breath.
- Subcutaneous tissue and skin: Stevens – Johnson syndrome.
- Immune system: hypersensitivity to the constituent elements of the drug.
- Digestive system: constipation, dyspeptic disorders, pancreatitis.
- Bile ducts and liver: impaired liver function tests, hepatitis.
- Urinary tract and kidneys: acute failure.
- Infections and parasitic diseases: fungal infection of the skin and mucous membranes.
- Hemopoietic organs: leukopenia (including neutropenia), agranulocytosis, thrombocytopenic purpura, thrombocytopenia, pancytopenia.
- General disorders: fatigue, general weakness.
In patients suffering from Alzheimer's disease, depressive states, thoughts of suicide, as well as attempts to commit it, were also recorded while taking this pharmacological drug.
Special recommendations
Patients with a predisposition to epilepsy or suffering from this pathology, as well as patients with a history of seizures, are advised to exercise caution during treatment with Memantine Canon. Since the simultaneous administration of the drug with other NMDA receptor antagonists (amantadine, ketamine, dextromethorphan) can more often cause undesirable reactions, and they can have a pronounced intensity (mainly at the central nervous system), it is recommended to avoid their combined use.
Careful monitoring of the patient's condition is necessary if he has factors that influence the increase in urine pH: drastic changes in nutrition (switch to a vegetarian diet, intensive use of gastric alkaline buffers); severe infectious diseases of the urinary canal; tubular renal acidosis.
Therapy with the drug "Memantine Canon" in patients with problems of the cardiovascular system should be carried out under the supervision of a cardiologist. In Alzheimer's disease at the stage of severe or moderate dementia, violations of the ability to control complex mechanisms and vehicles are often observed. In addition, the use of the Memantine Canon medical device can directly affect the speed of the reaction. In this regard, this category of patients should refrain from such events.
Use during pregnancy and lactation
Since there is no clinical data on the effect of this drug on pregnancy, it is contraindicated to use Memantine Canon in the period under review. In the course of scientific research, it was found that the active element of the drug can provoke a delay in fetal development when exposed to similar or superior concentrations (experiments were performed on animals).
There is no information on the excretion of the active substance with breast milk. However, experts suggest that due to its lipophilic structure, memantine can penetrate into breast milk, so taking the drug during the lactation process is contraindicated.
Drug interaction
With the combined use of the drug "Memantine Canon" with other drugs, the following drug interactions can be observed:
- M-anticholinergics, levodopa, dopamine receptor agonists: the effect of these substances can be enhanced, as well as when taken with other antagonists of NMDA receptors.
- Antipsychotics and barbiturates: there is a decrease in their action.
- Anticonvulsant medical substances (baclofen, dantrolene): the effect on their effectiveness is to enhance or weaken the therapeutic effect.
- Amantadine, ketamine, dextromethorphan: increased likelihood of developing psychosis and depressive states.
- Phenytoinum: the combined use is not recommended.
- Cimetidine, ranitidine, quinidine, procainamide, quinine, nicotine: their plasma concentration may increase, these elements use the same renal transport cationic system as memantine.
- Indirect anticoagulants (warfarin): MHO may increase.
- Hydrochlorothiazide (or any combination with hydrochlorothiazide): a decrease in the level of hydrochlorothiazide in the blood is possible. Despite the fact that a causal relationship has not been established, it is recommended to establish control over INR and prothrombin time in patients who take this medication in combination with warfarin.
- Monoamine oxidase inhibitors, antidepressants and serotonin uptake inhibitors: careful monitoring of the patient's condition is required.
What is the difference between Memantine and Memantine Canon?
Both drugs are highly effective in the treatment of Alzheimer's disease, as well as in cases of varying severity. These drugs are used as part of complex treatment and have an absolutely identical composition and form of release. Their main differences are that the drugs are produced by different pharmaceutical companies, and they are sold at different prices. Memantine medication is cheaper than Meminin Canon, so doctors often prescribe this option. The medicine costs about 400 rubles.
Analogs
The list of the main analogues of “Memantine Canon” includes the following medicines:
- "Alzame" is an absolute analogue of the medicine in question with an identical composition. This product is produced in Argentina.
- "Maruks" is the Russian analogue of the drug "Memantine Canon" based on memantine, but more expensive - almost twice.
- "Noogeron" - a medicine manufactured in Croatia, with memantine in the main composition. It is an absolute analogue of the drug "Memantine Canon". Despite this, it is a very expensive medication - its cost fluctuates around 2500 rubles.
A doctor should select a replacement.
Reviews
On medical sites and forums devoted to the discussion of medicines, there are quite a lot of positive comments about Memantine Canon. It is better to familiarize yourself with them in advance. Specialists call the "Memantine Canon" for Alzheimer's disease the best medicine. They also indicate that independent use of this remedy is out of the question, since this is a rather serious pharmacological product that can cause a lot of adverse reactions, most of which affect the structures of the nervous system. At the same time, the most common side symptom of drug treatment is a variety of mental disorders, including hallucinations and severe depressive states. In this regard, doctors do not recommend self-medication and purchase this drug without a prescription from a specialist.
Patients who were treated with the drug "Memantine Canon" or its analogues, note that the positive effect of therapy is not observed immediately. If the treatment did not provoke negative symptoms, then the result of taking the drug can be seen only after about a month of therapy.
As for the side effects of this medication, patients in the reviews write that from it, in almost every case, negative reactions of the body develop. The most harmless of them were dyspeptic disorders, which took place in most cases without the use of symptomatic treatment. More serious manifestations of side effects were a violation of the heart, pressure levels, changes in consciousness, severe dizziness. Reviews of the "Memantine Canon" confirm this.