{"id":54750,"date":"2023-09-20T10:02:54","date_gmt":"2023-09-20T10:02:54","guid":{"rendered":"https:\/\/medsname.com\/donamem\/"},"modified":"2026-04-30T16:30:23","modified_gmt":"2026-04-30T16:30:23","slug":"donamem","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/donamem\/","title":{"rendered":"Donamem"},"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>Donamem<\/strong> \u2014 fixn\u00ed kombinace donepezilu + memantinu (Sun Pharma). Kombinace inhibitoru cholinester\u00e1zy a antagonisty NMDA receptor\u016f pro st\u0159edn\u011b t\u011b\u017ekou a\u017e t\u011b\u017ekou Alzheimerovu chorobu. Dva komplement\u00e1rn\u00ed mechanismy v jedn\u00e9 tablet\u011b \u2014 m\u00edrn\u011b lep\u0161\u00ed kognitivn\u00ed a funk\u010dn\u00ed v\u00fdsledky ne\u017e u monoterapie.<\/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>Donamem je expedov\u00e1n od v\u00fdrobce certifikovan\u00e9ho WHO-GMP v neutr\u00e1ln\u00edm balen\u00ed, fakturov\u00e1n prost\u0159ednictv\u00edm regulovan\u00e9 platebn\u00ed br\u00e1ny (na v\u00fdpisu bude uveden regulovan\u00fd popis platebn\u00ed br\u00e1ny \u2014 nikdy MedsBase nebo n\u00e1zev l\u00e9ku). Ka\u017ed\u00e1 objedn\u00e1vka je kryta na\u0161\u00ed 20denn\u00ed z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed.<\/p>\n<h2>Pro\u010d je kombinovat<\/h2>\n<p>Donepezil (inhibitor cholinester\u00e1zy) a memantin (antagonista NMDA) c\u00edl\u00ed na r\u016fzn\u00e9 neurotransmiterov\u00e9 syst\u00e9my zapojen\u00e9 do Alzheimerovy choroby. \u010cetn\u00e9 studie (DOMINO-AD, Tariot 2004, Hartmann 2003) ukazuj\u00ed, \u017ee kombinovan\u00e1 terapie p\u0159in\u00e1\u0161\u00ed mal\u00fd, ale klinicky v\u00fdznamn\u00fd dodate\u010dn\u00fd benefit v kognitivn\u00edch (SIB, MMSE) a funk\u010dn\u00edch (ADCS-ADL) parametrech u st\u0159edn\u011b t\u011b\u017ek\u00e9ho a\u017e t\u011b\u017ek\u00e9ho onemocn\u011bn\u00ed ve srovn\u00e1n\u00ed s monoterapi\u00ed inhibitorem cholinester\u00e1zy. Fixn\u00ed kombinace zjednodu\u0161uje re\u017eim a zlep\u0161uje adherenci.<\/p>\n<h2>D\u00e1vkov\u00e1n\u00ed<\/h2>\n<p>K dispozici jako 5 mg + 5 mg nebo 10 mg + 5 mg (donepezil + memantin). Pacienti obvykle za\u010d\u00ednaj\u00ed postupn\u00fdm zvy\u0161ov\u00e1n\u00edm d\u00e1vky ka\u017ed\u00e9 slo\u017eky zvl\u00e1\u0161\u0165 (memantin 5 mg\/t\u00fdden a\u017e 10 mg 2\u00d7 denn\u011b; donepezil 5 mg \u2192 10 mg po 4 t\u00fddnech) p\u0159ed p\u0159echodem na fixn\u00ed kombinaci vhodn\u00e9 s\u00edly.<\/p>\n<p>U\u017e\u00edvat jednou denn\u011b ve\u010der. Upravit d\u00e1vku memantinu p\u0159i ren\u00e1ln\u00ed insuficienci (CrCl &lt;50 ml\/min) \u2014 fixn\u00ed kombinace nemus\u00ed b\u00fdt vhodn\u00e1; p\u0159ej\u00edt na odd\u011blen\u00e9 slo\u017eky.<\/p>\n<h2>Vedlej\u0161\u00ed \u00fa\u010dinky (kombinovan\u00fd profil)<\/h2>\n<ul>\n<li>GIT: nevolnost, zvracen\u00ed, pr\u016fjem, nechutenstv\u00ed, \u00fabytek hmotnosti (slo\u017eka donepezil)<\/li>\n<li>CNS: nespavost, \u017eiv\u00e9 sny, z\u00e1vrat\u011b, ospalost, bolest hlavy (ob\u011b slo\u017eky)<\/li>\n<li>Kardi\u00e1ln\u00ed: bradykardie, AV blok (donepezil)<\/li>\n<li>M\u00e9n\u011b \u010dast\u00e9: halucinace, zmatenost (slo\u017eka memantin, zejm\u00e9na b\u011bhem titrace)<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Anticholinergn\u00ed interference<\/strong><br \/>Vyhn\u011bte se sou\u010dasn\u00e9mu pod\u00e1v\u00e1n\u00ed anticholinergn\u00edch l\u00e9k\u016f (oxybutynin, tolterodin, hyoscin, TCA, antihistaminika prvn\u00ed generace) \u2013 p\u016fsob\u00ed proti \u00fa\u010dinku donepezilu a samostatn\u011b zhor\u0161uj\u00ed kognici. P\u0159i hyperaktivn\u00edm mo\u010dov\u00e9m m\u011bch\u00fd\u0159i u demence preferujte mirabegron.<\/div>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>M\u00e1m za\u010d\u00edt p\u0159\u00edmo s kombinac\u00ed?<\/h3>\n<p>Ne \u2013 oba l\u00e9ky vy\u017eaduj\u00ed pomalou titraci pro zvl\u00e1dnut\u00ed GIT (donepezil) a CNS (memantin) ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f. V\u011bt\u0161ina klinik\u016f nejprve titruje ka\u017ed\u00fd l\u00e9k zvl\u00e1\u0161\u0165 a teprve pot\u00e9 p\u0159ech\u00e1z\u00ed na fixn\u00ed kombinaci, kdy\u017e pacient dos\u00e1hne stabiln\u00ed c\u00edlov\u00e9 d\u00e1vky.<\/p>\n<h3>Jak\u00fd p\u0159\u00ednos m\u00e1 kombinace oproti samotn\u00e9mu donepezilu?<\/h3>\n<p>M\u00edrn\u00fd dodate\u010dn\u00fd p\u0159\u00ednos v kognitivn\u00edch a funk\u010dn\u00edch m\u011b\u0159en\u00edch (obvykle 1-2 body na SIB nebo 0,5-1 bod na ADCS-ADL) u st\u0159edn\u011b t\u011b\u017ek\u00e9 a\u017e t\u011b\u017ek\u00e9 demence. Efekt je mal\u00fd, ale pro n\u011bkter\u00e9 rodiny klinicky v\u00fdznamn\u00fd.<\/p>\n<h3>A co ne\u017e\u00e1douc\u00ed \u00fa\u010dinky?<\/h3>\n<p>Kumuluj\u00ed se z obou slo\u017eek: nevolnost, pr\u016fjem, bolest hlavy (donepezil); z\u00e1vrat\u011b, z\u00e1cpa, bolest hlavy (memantin). V\u011bt\u0161ina je d\u00e1vkov\u011b limituj\u00edc\u00ed pouze p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch nebo rychl\u00e9 titraci.<\/p>\n<h3>Selh\u00e1n\u00ed ledvin?<\/h3>\n<p>Slo\u017eka memantin je ren\u00e1ln\u011b eliminov\u00e1na. Pokud CrCl &lt;50 ml\/min, p\u0159ejd\u011bte na odd\u011blen\u00e9 slo\u017eky m\u00edsto fixn\u00ed kombinace, aby bylo mo\u017en\u00e9 memantin d\u00e1vkovat nez\u00e1visle.<\/p>\n<h3>Kdy by m\u011bla b\u00fdt kombinace ukon\u010dena?<\/h3>\n<p>P\u0159ehodno\u0165te v 6\u201312m\u011bs\u00ed\u010dn\u00edch intervalech. Ukon\u010dete p\u0159i pokro\u010dil\u00e9m onemocn\u011bn\u00ed, kdy se c\u00edle posunou k p\u00e9\u010di zam\u011b\u0159en\u00e9 na pohodl\u00ed, nebo pokud vedlej\u0161\u00ed \u00fa\u010dinky (zejm\u00e9na \u00fabytek hmotnosti, synkopa) p\u0159eva\u017euj\u00ed nad vn\u00edman\u00fdm p\u0159\u00ednosem.<\/p>\n<h3>M\u016f\u017ee zpomalit onemocn\u011bn\u00ed?<\/h3>\n<p>Ne \u2014 oba l\u00e9ky jsou symptomatick\u00e9. Nezpomaluj\u00ed podkladovou neurodegeneraci.<\/p>\n<h3>Interakce l\u00e9k\u016f?<\/h3>\n<p>Slo\u017eka donepezil interaguje s anticholinergiky (kter\u00e9 p\u016fsob\u00ed proti jeho \u00fa\u010dinku) a bradykardizuj\u00edc\u00edmi l\u00e9ky. Memantin interaguje s dal\u0161\u00edmi antagonisty NMDA a l\u00e1tkami alkalizuj\u00edc\u00edmi mo\u010d. \u00dapln\u00e9 seznamy interakc\u00ed naleznete na jednotliv\u00fdch str\u00e1nk\u00e1ch produkt\u016f.<\/p>\n<h3>Co kdy\u017e vynech\u00e1te d\u00e1vku?<\/h3>\n<p>Vynechejte vynechanou d\u00e1vku a pokra\u010dujte v b\u011b\u017en\u00e9m sch\u00e9matu. Pokud bylo vynech\u00e1no n\u011bkolik dn\u00ed, za\u010dn\u011bte znovu s odd\u011blen\u00fdmi slo\u017ekami na ni\u017e\u0161\u00edm stupni titrace, aby se p\u0159ede\u0161lo vedlej\u0161\u00edm \u00fa\u010dink\u016fm.<\/p>\n<h3>M\u016f\u017ee m\u016fj bl\u00edzk\u00fd \u0159\u00eddit?<\/h3>\n<p>Stabiln\u00ed pacienti na c\u00edlov\u00e9 d\u00e1vce obvykle mohou \u0159\u00eddit. Po\u010d\u00e1te\u010dn\u00ed titrace m\u016f\u017ee zp\u016fsobit z\u00e1vrat\u011b a ospalost \u2014 ne\u0159i\u010fte, dokud se stav nestabilizuje. Schopnost \u0159\u00eddit by m\u011bla b\u00fdt pravideln\u011b p\u0159ehodnocov\u00e1na s postupuj\u00edc\u00ed demenc\u00ed bez ohledu na medikaci.<\/p>\n<h3>Je rozd\u00edl mezi silami 5+5 a 10+5?<\/h3>\n<p>S\u00edla 10+5 obsahuje pln\u011b titrovanou d\u00e1vku donepezilu (10 mg) plus polovi\u010dn\u00ed d\u00e1vku memantinu (5 mg). Pln\u011b titrovan\u00fd c\u00edl memantinu je 10 mg dvakr\u00e1t denn\u011b \u2014 tak\u017ee v\u011bt\u0161ina pacient\u016f na kombinaci pot\u0159ebuje bu\u010f dv\u011b s\u00edly 5+5, nebo jednu s\u00edlu 10+5 plus samostatnou ve\u010dern\u00ed d\u00e1vku memantinu 5 mg. Potvr\u010fte re\u017eim s p\u0159edepisuj\u00edc\u00edm l\u00e9ka\u0159em.<\/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\/alzil\/\">Alzil<\/a> \u2014 monoterapie donepezilem 5\/10 mg<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/donep\/\">Donep<\/a> \u2014 donepezil 5\/10 mg<\/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\/nemdaa\/\">Nemdaa<\/a> \u2014 memantin 5\/10 mg monoterapie<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ashvagandha\/\">Ashvagandha<\/a> \u2014 Ajurv\u00e9dsk\u00fd adaptogen \u2014 pouze dopl\u0148kov\u00e1, nikoli n\u00e1hradn\u00ed terapie<\/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>Donamem (Donepezil + Memantin) \u2014 kombinovan\u00fd p\u0159\u00edpravek od Sun Pharma pro zlep\u0161en\u00ed kognitivn\u00edch funkc\u00ed u st\u0159edn\u011b t\u011b\u017ek\u00e9 a\u017e t\u011b\u017ek\u00e9 Alzheimerovy choroby. Du\u00e1ln\u00ed mechanismus \u00fa\u010dinku c\u00edlen\u00fd na acetylcholinov\u00fd a glutam\u00e1tov\u00fd syst\u00e9m.<\/p>","protected":false},"featured_media":54751,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3772,3141,3223],"product_tag":[3777],"class_list":{"0":"post-54750","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","9":"product_tag-donamem","11":"first","12":"outofstock","13":"shipping-taxable","14":"purchasable","15":"product-type-variable","16":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/54750","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=54750"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/54751"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=54750"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=54750"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=54750"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=54750"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}