{"id":54711,"date":"2023-09-20T10:02:23","date_gmt":"2023-09-20T10:02:23","guid":{"rendered":"https:\/\/medsname.com\/nemdaa\/"},"modified":"2026-04-30T16:30:23","modified_gmt":"2026-04-30T16:30:23","slug":"nemdaa","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/nemdaa\/","title":{"rendered":"Nemdaa"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">Rychl\u00e1 odpov\u011b\u010f<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Nemdaa<\/strong> \u2014 memantine 5\/10 mg (Intas Pharma). Nekompetitivn\u00ed antagonista NMDA-receptor\u016f s n\u00edzkou afinitou pro st\u0159edn\u011b t\u011b\u017ekou a\u017e t\u011b\u017ekou Alzheimerovu chorobu. \u010casto kombinov\u00e1n s inhibitorem cholinester\u00e1zy (donepezil). M\u00edrn\u00fd symptomatick\u00fd benefit; vy\u017eaduje \u00fapravu d\u00e1vkov\u00e1n\u00ed p\u0159i ren\u00e1ln\u00edm posti\u017een\u00ed.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f7f7f7;border-left:4px solid #2c7cb0;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0 0 6px 0;\"><strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/li>\n<li>Diskr\u00e9tn\u00ed balen\u00ed v oby\u010dejn\u00e9 ob\u00e1lce<\/li>\n<li>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/li>\n<li>Hodnoceno v\u00edce ne\u017e 1 400 z\u00e1kazn\u00edky (<a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">\u010d\u00edst recenze<\/a>)<\/li>\n<\/ul>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:10px 14px;margin:14px 0;border-radius:3px;\">\ud83d\udce6 <strong>Z\u00e1ruka op\u011btovn\u00e9ho zasl\u00e1n\u00ed:<\/strong> pokud va\u0161e objedn\u00e1vka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f od odesl\u00e1n\u00ed, za\u0161leme ji znovu bez dal\u0161\u00edch n\u00e1klad\u016f. <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">P\u0159e\u010d\u00edst podm\u00ednky<\/a>.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Nemdaa je expedov\u00e1n od v\u00fdrobce s certifikac\u00ed WHO-GMP v neutr\u00e1ln\u00edm balen\u00ed, platba prob\u00edh\u00e1 p\u0159es regulovan\u00e9ho platebn\u00edho procesora (na v\u00fdpisu z \u00fa\u010dtu se objev\u00ed regulovan\u00fd platebn\u00ed procesor \u2014 nikoli MedsBase nebo n\u00e1zev l\u00e9ku). Ka\u017ed\u00e1 objedn\u00e1vka je kryta na\u0161\u00ed 20pracovnodenn\u00ed z\u00e1rukou na p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2>Jak memantin funguje<\/h2>\n<p>U Alzheimerovy choroby se glutam\u00e1t hromad\u00ed v synaptick\u00e9 \u0161t\u011brbin\u011b a chronicky nadm\u011brn\u011b aktivuje NMDA receptory, co\u017e p\u0159isp\u00edv\u00e1 k excitotoxicit\u011b a kognitivn\u00edmu \u00fabytku. Memantin je n\u00edzkou afinitou nekompetitivn\u00ed NMDA antagonista \u2014 blokuje patologick\u00e9 tonick\u00e9 glutam\u00e1tov\u00e9 signalizace bez blokov\u00e1n\u00ed vysok\u00fdch amplitud f\u00e1zick\u00fdch sign\u00e1l\u016f pot\u0159ebn\u00fdch pro norm\u00e1ln\u00ed u\u010den\u00ed a pam\u011b\u0165. Tato selektivita je d\u016fvodem, pro\u010d se li\u0161\u00ed od star\u0161\u00edch NMDA antagonist\u016f (ketamin, MK-801), kter\u00e9 blokuj\u00ed ve\u0161kerou NMDA aktivitu a nejsou tolerov\u00e1ny jako kognitivn\u00ed l\u00e9ky.<\/p>\n<h2>D\u00e1vkov\u00e1n\u00ed \u2014 pomal\u00e1 titrace<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:12px 0;\">\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;border:1px solid #ddd;\">T\u00fdden<\/th>\n<th style=\"padding:8px;border:1px solid #ddd;\">D\u00e1vka<\/th>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">1<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">5 mg jednou denn\u011b (r\u00e1no)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">2<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">5 mg dvakr\u00e1t denn\u011b (r\u00e1no + ve\u010der)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">3<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">10 mg r\u00e1no + 5 mg ve\u010der<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">4 a v\u00fd\u0161e<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">10 mg dvakr\u00e1t denn\u011b (c\u00edlov\u00e9 d\u00e1vkov\u00e1n\u00ed)<\/td>\n<\/tr>\n<\/table>\n<p>Pomal\u00e1 titrace minimalizuje ne\u017e\u00e1douc\u00ed \u00fa\u010dinky CNS (z\u00e1vrat\u011b, zmatenost, sedace). Formulace s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm (28 mg jednou denn\u011b, kde je dostupn\u00e1) se tak\u00e9 titruje t\u00fddn\u011b.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>\u00daprava d\u00e1vkov\u00e1n\u00ed p\u0159i ren\u00e1ln\u00ed insuficienci<\/strong><br \/>Memantin je vylu\u010dov\u00e1n ledvinami. Upravte d\u00e1vku podle clearance kreatininu:<br \/>\u2022 ClCr &gt;50 ml\/min: standardn\u00ed d\u00e1vkov\u00e1n\u00ed (c\u00edlov\u00e9 10 mg 2\u00d7 denn\u011b)<br \/>\u2022 ClCr 30-50 ml\/min: c\u00edlov\u00e9 5 mg 2\u00d7 denn\u011b (celkem 10 mg\/den)<br \/>\u2022 ClCr 5-29 ml\/min: 5 mg 2\u00d7 denn\u011b (pod odborn\u00fdm dohledem)<br \/>\u2022 Dial\u00fdza: nen\u00ed dob\u0159e prostudov\u00e1no \u2014 pou\u017e\u00edvejte pouze, pokud p\u0159\u00ednos jasn\u011b p\u0159ev\u00e1\u017e\u00ed riziko<\/div>\n<h2>Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<ul>\n<li>\u010cast\u00e9: z\u00e1vrat\u011b, bolest hlavy, z\u00e1cpa, ospalost, p\u0159ib\u00fdv\u00e1n\u00ed na v\u00e1ze<\/li>\n<li>M\u00e9n\u011b \u010dast\u00e9: zmatenost, halucinace, hypertenze, agitace<\/li>\n<li>Vz\u00e1cn\u00e9: z\u00e1chvaty, psych\u00f3za (obvykle u predisponovan\u00fdch jedinc\u016f)<\/li>\n<\/ul>\n<h2>Interakce l\u00e9k\u016f<\/h2>\n<ul>\n<li>Jin\u00e9 NMDA antagonisty (amantadin, ketamin, dextromethorfan): aditivn\u00ed \u00fa\u010dinky na CNS \u2014 vyvarujte se<\/li>\n<li>Alkaliz\u00e1tory mo\u010di (hydrogenuhli\u010ditan sodn\u00fd, acetazolamid): sni\u017euj\u00ed ren\u00e1ln\u00ed clearance \u2014 monitorujte<\/li>\n<li>Hydrochlorothiazid: sni\u017euje hladiny hydrochlorothiazidu o ~20% \u2014 obvykle klinicky nev\u00fdznamn\u00e9<\/li>\n<li>Cimetidin, ranitidin, chinidin, nikotin: drobn\u00e9 interakce prost\u0159ednictv\u00edm sd\u00edlen\u00e9ho ren\u00e1ln\u00edho kationtov\u00e9ho transportu<\/li>\n<\/ul>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Kdy by m\u011bl b\u00fdt memantin p\u0159id\u00e1n?<\/h3>\n<p>Memantin je schv\u00e1len pro st\u0159edn\u011b t\u011b\u017ekou a\u017e t\u011b\u017ekou Alzheimerovu chorobu (typicky MMSE \u226419 nebo po dosa\u017een\u00ed funk\u010dn\u00edho plateau p\u0159i monoterapii donepezilem). Kombinace donepezil + memantin u st\u0159edn\u011b t\u011b\u017ek\u00e9ho a\u017e t\u011b\u017ek\u00e9ho onemocn\u011bn\u00ed m\u00e1 aditivn\u00ed benefit.<\/p>\n<h3>Vedlej\u0161\u00ed \u00fa\u010dinky?<\/h3>\n<p>Obecn\u011b dob\u0159e sn\u00e1\u0161en. \u010cast\u00e9: z\u00e1vrat\u011b, bolesti hlavy, z\u00e1cpa, ospalost. M\u00e9n\u011b \u010dast\u00e9: halucinace, agitace, zmatenost (obvykle p\u0159echodn\u00e9). Pomalu titrujte.<\/p>\n<h3>M\u016f\u017ee b\u00fdt kombinov\u00e1n s donepezilem?<\/h3>\n<p>Ano \u2014 kombinace je standardem u st\u0159edn\u011b t\u011b\u017ek\u00e9ho a\u017e t\u011b\u017ek\u00e9ho onemocn\u011bn\u00ed. Oba l\u00e9ky p\u016fsob\u00ed na r\u016fzn\u00e9 neurotransmiterov\u00e9 syst\u00e9my (acetylcholin vs glutam\u00e1t) a maj\u00ed aditivn\u00ed kognitivn\u00ed benefit bez v\u00fdznamn\u00fdch l\u00e9kov\u00fdch interakc\u00ed.<\/p>\n<h3>A co funkce ledvin?<\/h3>\n<p>Memantin je vylu\u010dov\u00e1n ledvinami. Sni\u017ete d\u00e1vku p\u0159i CrCl &lt;50 ml\/min. U star\u0161\u00edch pacient\u016f na dlouhodob\u00e9 terapii v\u017edy monitorujte ren\u00e1ln\u00ed funkci.<\/p>\n<h3>Zastav\u00ed nebo zpomal\u00ed onemocn\u011bn\u00ed?<\/h3>\n<p>Ne \u2014 memantin je symptomatick\u00fd, nikoli modifikuj\u00edc\u00ed pr\u016fb\u011bh onemocn\u011bn\u00ed. M\u016f\u017ee m\u00edrn\u011b zpomalit funk\u010dn\u00ed \u00fapadek a odd\u00e1lit miln\u00edky zv\u00fd\u0161en\u00e9 p\u00e9\u010de, ale neovliv\u0148uje z\u00e1kladn\u00ed neurodegeneraci.<\/p>\n<h3>Mimo schv\u00e1len\u00e9 indikace?<\/h3>\n<p>Memantin byl studov\u00e1n mimo schv\u00e1len\u00e9 indikace pro vaskul\u00e1rn\u00ed demenci, augmentaci l\u00e9\u010dby OCD, neuropatickou bolest, poruchy u\u017e\u00edv\u00e1n\u00ed alkoholu a profylaxi migr\u00e9ny \u2014 d\u016fkazy jsou sm\u00ed\u0161en\u00e9 a v\u011bt\u0161ina pou\u017eit\u00ed je pouze v\u00fdzkumn\u00e1.<\/p>\n<h3>Interakce l\u00e9k\u016f?<\/h3>\n<p>Minimum klinicky v\u00fdznamn\u00fdch interakc\u00ed. Vyhn\u011bte se kombinaci s jin\u00fdmi NMDA antagonisty (amantadin, ketamin, dextromethorfan) \u2014 aditivn\u00ed \u00fa\u010dinky na CNS. L\u00e1tky alkalizuj\u00edc\u00ed mo\u010d (hydrogenuhli\u010ditan sodn\u00fd, acetazolamid) sni\u017euj\u00ed clearance memantinu a zvy\u0161uj\u00ed jeho hladiny.<\/p>\n<h3>Co kdy\u017e vynech\u00e1te d\u00e1vku?<\/h3>\n<p>Vynechejte vynechanou d\u00e1vku a pokra\u010dujte v obvykl\u00e9m sch\u00e9matu. Pokud bylo vynech\u00e1no n\u011bkolik dn\u00ed, za\u010dn\u011bte znovu ni\u017e\u0161\u00ed po\u010d\u00e1te\u010dn\u00ed d\u00e1vkou a postupn\u011b zvy\u0161ujte, abyste p\u0159ede\u0161li ne\u017e\u00e1douc\u00edm \u00fa\u010dink\u016fm na CNS.<\/p>\n<h3>Kdy by m\u011bl b\u00fdt vysazen?<\/h3>\n<p>P\u0159ehodno\u0165te ka\u017ed\u00fdch 6 m\u011bs\u00edc\u016f. P\u0159esta\u0148te, pokud nen\u00ed patrn\u00fd benefit, pokud ne\u017e\u00e1douc\u00ed \u00fa\u010dinky p\u0159eva\u017euj\u00ed nad p\u0159\u00ednosy, nebo v pokro\u010dil\u00e9m stadiu onemocn\u011bn\u00ed, kdy se c\u00edle m\u011bn\u00ed na p\u00e9\u010di zam\u011b\u0159enou na pohodl\u00ed.<\/p>\n<h3>Mohu \u0159\u00eddit?<\/h3>\n<p>Po\u010d\u00e1te\u010dn\u00ed titrace zp\u016fsobuje u n\u011bkter\u00fdch pacient\u016f z\u00e1vrat\u011b a ospalost \u2014 ne\u0159i\u010fte, dokud nedos\u00e1hnete stabiln\u00ed udr\u017eovac\u00ed d\u00e1vky. V\u011bt\u0161ina pacient\u016f na stabiln\u00ed terapii m\u016f\u017ee \u0159\u00eddit bez omezen\u00ed.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Dal\u0161\u00ed l\u00e9ky na Alzheimerovu chorobu a demenci<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/donamem\/\">Donamem<\/a> \u2014 fixn\u00ed kombinace donepezilu a memantinu<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/alzil\/\">Alzil<\/a> \u2014 donepezil 5\/10 mg<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/donep\/\">Donep<\/a> \u2014 donepezil 5\/10 mg \u2014 zna\u010dka Alkem<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/donecept\/\">Donecept<\/a> \u2014 donepezil 5\/10 mg \u2014 zna\u010dka Cipla<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ashvagandha\/\">Ashvagandha<\/a> \u2014 ajurv\u00e9dsk\u00fd adaptogen \u2014 pouze dopl\u0148kov\u00e1 terapie, NEN\u00cd n\u00e1hradou za p\u0159edepsanou l\u00e9\u010dbu demence<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:18px 0;border-radius:3px;font-size:.95em;\"><strong>Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informaci a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho odborn\u00edka. Proberte jak\u00e9koli nov\u00e9 l\u00e9ky se sv\u00fdm l\u00e9ka\u0159em nebo l\u00e9k\u00e1rn\u00edkem.<\/div>","protected":false},"excerpt":{"rendered":"<p>Nemdaa (Memantine 5\/10 mg) \u2014 nekompetitivn\u00ed antagonista NMDA-receptor\u016f od spole\u010dnosti Intas Pharma pro st\u0159edn\u011b t\u011b\u017ekou a\u017e t\u011b\u017ekou Alzheimerovu chorobu. Pomal\u00e1 titrace na 10 mg dvakr\u00e1t denn\u011b; \u00faprava d\u00e1vkov\u00e1n\u00ed p\u0159i ren\u00e1ln\u00edm posti\u017een\u00ed.<\/p>","protected":false},"featured_media":54712,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3772,3141,3223],"product_tag":[],"class_list":{"0":"post-54711","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-alzheimers-treatment","7":"product_cat-category-overview","8":"product_cat-chronic-conditions","10":"first","11":"outofstock","12":"shipping-taxable","13":"purchasable","14":"product-type-variable","15":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/54711","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=54711"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/54712"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=54711"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=54711"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=54711"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=54711"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}