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Memantine/donepezil, sold under the brand name Namzaric among others, is a fixed dose combination medication used for the treatment of dementia of the Alzheimer's type. [1] It contains memantine , as the hydrochloride, a NMDA receptor antagonist ; and donepezil as the hydrochloride, an acetylcholinesterase inhibitor . [ 1 ]
Donepezil binds and reversibly inhibits enzymes called cholinesterases, especially acetylcholinesterase, thus inhibiting hydrolysis of acetylcholine. This increases acetylcholine concentrations at cholinergic synapses. [5] The precise mechanism of action of donepezil in patients with Alzheimer's disease is not fully understood.
The SPC is not intended to give general advice about treatment of a condition but does state how the product is to be used for a specific treatment. It forms the basis of information for health professionals to know how to use the specific product safely and effectively. The package leaflet supplied with the product is aimed at end-users. [3]
Some inhibitors like donepezil (Aricept) can be used during any stage of the disease, while others, like the skin patch form of rivastigmine (Exelon), are specifically for severe Alzheimer's.
Paraoxon and rivastigmine are both acetylcholinesterase inhibitors and butyrylcholinesterase inhibitors. [14] [11] [7]In 2015, the United States Food and Drug Administration's Adverse Event Reporting System database compared rivastigmine to the other ChEI drugs donepezil and galantamine found that rivastigmine was associated with a higher frequency of reports of death as an adverse event.
The irreversible phosphorylation of the cholinesterase occurs in two steps. In the first step the cholinesterase gets reversibly phosphorylated. This reaction is very fast. Then the second step takes place. The cholinesterase forms a very stable complex with TEPP, in which TEPP is covalently bound to the cholinesterase. This is a slow reaction.
Researchers found that patients with musical hallucinations respond well to the drug Donepezil, making it another potential treatment for the condition. Donepezil, which belongs to a class of medication called acetylcholinesterase inhibitors , is most commonly used to treat dementia in patients with Alzheimer's disease.
Side-effects and ADRs associated with donepezil can be classified in two main categories: common side-effects, most of them observed in clinical trials with AD patients, and unfrequent or extraordinary side-effects, seen in especial conditions or in small clusters of patients with different pathologies under treatment with other concomitant drugs.