CLINICAL USE


Mild-moderate dementia in Alzheimer’s diseaseIdiopathic Parkinson’s disease

DOSE IN NORMAL RENAL FUNCTION

3–6 mg twice daily (initially 1.5 mg twice daily)

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :250.3 (400.4 as hydrogen tartrate)
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :40
  • %Excreted unchanged in urine &nbsp &nbsp : 0 (>90 as pharmacologically inactive metabolites)
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :1.8–2.7
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :1/–

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Start at a low dose and gradually increase
  • 10 to 20 &nbsp &nbsp : Start at a low dose and gradually increase
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Start at a low dose and gradually increase

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Likely dialysability. Dose as in GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Likely dialysability. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Likely dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp:Likely dialysability. Dose as in GFR=10-20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsMuscle relaxants: enhances effect of suxamethonium; antagonises effect of non-depolarising muscle relaxants

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments

    OTHER INFORMATION

    Administer with food. Swallow whole .