Admenta

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What Is Admenta?

Admenta is an oral tablet from Sun Pharma containing memantine hydrochloride 5 mg. Memantine is a low-affinity, voltage-dependent, uncompetitive antagonist of the N-methyl-D-aspartate (NMDA) glutamate receptor. It is mechanistically distinct from the cholinesterase inhibitors (donepezil, galantamine, rivastigmine) and works through the second major pathway implicated in Alzheimer's disease — glutamate excitotoxicity.

Admenta from Sun Pharma is a 5 mg memantine tablet — the strength used during the mandatory 4-week up-titration to the 20 mg/day maintenance dose. Maintenance dosing is two 5 mg tablets twice daily (4 tablets total per day). Memantine is licensed only for moderate-to-severe Alzheimer's disease — not mild. It is the standard add-on to a cholinesterase inhibitor (typically donepezil) when patients progress past the mild stage, and produces additive cognitive and functional benefit with minimal increase in side effects.

How Does Admenta Work?

Alzheimer's disease causes chronic excessive glutamate signalling at NMDA receptors — a process called glutamate excitotoxicity. Constant low-level NMDA activation damages neurons and disrupts the signal-to-noise ratio that the brain needs for learning and memory. Memantine addresses this through a unique mechanism:

• Voltage-dependent NMDA blockade — memantine binds to NMDA receptor channels but only when they are already open. It blocks chronic low-level excitotoxic activation but releases the receptor during high-amplitude physiological signalling needed for learning. This is the key difference between memantine and older NMDA blockers like ketamine, which block both modes and cause cognitive impairment.
• Restores signal-to-noise ratio — by reducing background glutamate noise, memantine improves the brain's ability to detect meaningful signals during learning and memory tasks.
• Neuroprotective effect — reduced excitotoxicity may slow the progression of neuronal damage, though this has not been definitively shown to translate into a clinically meaningful disease-modifying effect.

Onset of cognitive benefit: visible at 4–12 weeks after reaching the maintenance 20 mg/day dose; peak benefit at 6 months.

— det forstærker den normale fysiologiske respons snarere end at udløse en kunstigt.

• Moderate-to-severe Alzheimer's dementia — first-line indication
• Combination therapy with a cholinesterase inhibitor — standard of care in moderate-to-severe Alzheimer's; additive cognitive benefit
• Vascular dementia (mixed type) — off-label modest benefit
• Dementia with Lewy bodies — off-label, useful for behavioural symptoms

Admenta is ikke indicated for: mild Alzheimer's disease (cholinesterase inhibitors are first-line at this stage), mild cognitive impairment without dementia, frontotemporal dementia, or as a cognitive enhancer in healthy adults.

Admenta Dosage and How to Take — SLOW TITRATION

Admenta comes at 5 mg tablets. The titration schedule is mandatory — jumping straight to 20 mg/day causes intolerable confusion and dizziness in most patients.

Standard 4-week titration:

• Week 1: 5 mg once daily (1 tablet morning)
• Week 2: 10 mg/day = 5 mg twice daily (morning + evening)
• Week 3: 15 mg/day = 10 mg morning + 5 mg evening
• Week 4 onward (maintenance): 20 mg/day = 10 mg twice daily

How to Take Admenta Properly

1. Take with or without food — food does not affect absorption.
2. Slug hel med vand. Standard tablets can be split if scored.
3. Twice daily at maintenance dose (10 mg morning + 10 mg evening), spaced about 12 hours apart.
4. Renal dose adjustment: if estimated GFR is 30–49 mL/min, cap maintenance dose at 10 mg/day. If eGFR is 5–29 mL/min, maintenance dose is 10 mg/day. Avoid in eGFR < 5 mL/min.
5. Missed dose: if remembered the same day, take it. If remembered the next day, skip and resume normally — do not double-dose.
6. If treatment is interrupted for more than a few days, restart at 5 mg/day and re-titrate over 4 weeks. Memantine has no acute discontinuation syndrome but the slow titration is needed to avoid side effects.
7. Caregiver supervision is critical — patients with moderate-severe Alzheimer's rarely manage twice-daily dosing reliably without support. Use a weekly pill organiser filled by a family member or carer.
8. Re-assess after 6 months with formal cognitive testing (MMSE or MoCA). Continue if there is benefit or stabilisation; stop gradually if clear deterioration despite full-dose treatment.

Side Effects of Admenta

Common (worst during titration, settle once on maintenance):

• Svimmelhed
• Hovedpine
• Confusion or worsening confusion (often improves once on stable maintenance dose)
• Constipation
• Sleepiness or fatigue
• Hypertension (mild rise in BP)

Mindre almindelige:

• Hallucinations or worsening of existing hallucinations
• Agitation or aggression (paradoxical, especially during titration)
• Falls (from dizziness)
• Urinary tract infections

Rare but seek medical review:

• Seizures
• Severe psychiatric symptoms (psychosis, mania)
• Pancreatitis
• Hepatitis
• Stevens-Johnson syndrome (case reports)

Advarsler og forholdsregler

• Nedsat nyrefunktion: dose reduction is mandatory. Cap at 10 mg/day if eGFR 5–49 mL/min. Avoid if eGFR < 5 mL/min. Memantine accumulates in renal failure and causes toxicity.
• Urinary alkalisation: conditions that raise urine pH (severe UTI, renal tubular acidosis, vegetarian diet with high-dose alkalinising drugs, sodium bicarbonate) reduce memantine clearance and raise blood levels — monitor for side effects.
• Seizure history: use cautiously — memantine may lower seizure threshold.
• Recent myocardial infarction, uncontrolled hypertension, severe heart failure: caution — not enough safety data in these populations.
• Nedsat leverfunktion: no dose adjustment for mild-moderate; caution in severe.
• Hallucinations and delusions: can worsen pre-existing psychiatric symptoms in some patients with dementia. Monitor for behavioural changes.
• Caregiver support: patients in the moderate-severe Alzheimer's population for whom memantine is indicated rarely manage their own medication. Caregiver involvement in dose preparation, supervision and adherence is essential.

Contraindications — Who Should NOT Take Admenta

• Known hypersensitivity to memantine or any tablet excipient
• Severe renal impairment (eGFR < 5 mL/min)
• Mild Alzheimer's dementia (use a cholinesterase inhibitor first)
• Mild cognitive impairment without dementia
• Frontotemporal dementia (no benefit and may worsen behavioural symptoms)

Lægemiddelinteraktioner

Opbevaringsvejledning

• Opbevar ved stuetemperatur, 15–25°C. Protect from light and moisture.
• Keep tablets in the original blister pack until use.
• Do not store in the bathroom — humidity shortens shelf life.
• Keep out of reach of children and patients who may not understand they are medication.
• Brug ikke efter den udløbsdato, der er angivet på pakningen.
• Return unused tablets to a pharmacy for disposal.

Relaterede alternativer på MedsBase

Other Alzheimer's and dementia medications stocked on MedsBase:

• Aricep (donepezil 5 / 10 mg)
• Donect (donepezil 10 mg)
• Donemax (donepezil 10 mg)
• Galamer (galantamine 4 mg)
• Rivamer (rivastigmine 1.5 mg)

Nyttig læsning: Everything you need to know about Alzheimer's disease · Everything to know about dementia · 7 ways to protect your brain health as you age · Best foods for a healthy brain and improved memory.

Ofte stillede spørgsmål

Why is Admenta only for moderate-to-severe Alzheimer's?

Trials show no clinically meaningful cognitive benefit from memantine in mild Alzheimer's — the glutamate excitotoxicity pathway becomes a dominant driver of symptoms only later in the disease. For mild Alzheimer's, a cholinesterase inhibitor (donepezil, galantamine, rivastigmine) is first-line. Memantine is added when the patient progresses to moderate or severe disease.

Can Admenta be combined with donepezil?

Yes — this is the standard combination for moderate-to-severe Alzheimer's disease. The two drugs work on different pathways (cholinergic + glutamatergic) and produce additive cognitive and functional benefit. There is no significant pharmacokinetic interaction. Combination therapy is more effective than either drug alone at the moderate-to-severe stage. Aricep (donepezil) is the standard partner.

Why does Admenta need a 4-week titration?

Jumping to the 20 mg/day maintenance dose on day one causes intolerable confusion, dizziness and sometimes hallucinations — bad enough that most patients discontinue. The 4-week up-titration (5 → 10 → 15 → 20 mg/day) lets the brain adapt to NMDA blockade gradually. Skipping titration is the most common reason patients “cannot tolerate” memantine.

When will I or my family member see results?

Visible cognitive benefit at 4–12 weeks after reaching the 20 mg/day maintenance dose; peak benefit at 6 months. Like donepezil, memantine is symptomatic therapy, not disease-modifying. Re-assess with formal cognitive testing at 6 months.

Does Admenta need dose adjustment for kidney problems?

Yes. Memantine is renally cleared and accumulates in kidney impairment. Dose caps: eGFR 30–49 mL/min — cap maintenance at 10 mg/day. eGFR 5–29 mL/min — maintenance 10 mg/day. eGFR < 5 mL/min — avoid memantine entirely. Check kidney function before starting and at any sign of toxicity (confusion, sleepiness, dizziness on a previously stable dose).

Is Admenta a cure or does it slow Alzheimer's progression?

Neither. Memantine is symptomatic therapy — it stabilises function for a window of typically 6–18 months. The underlying neurodegeneration continues. Newer disease-modifying drugs (anti-amyloid antibodies like lecanemab and donanemab) target the underlying pathology but require IV infusion, regular MRI monitoring, and specialist supervision — they are not stocked here.

Does Admenta help with behavioural symptoms (agitation, aggression, hallucinations)?

Modest benefit on agitation and aggression in moderate-severe Alzheimer's — one of the reasons memantine is the preferred add-on at this stage rather than a second cholinesterase inhibitor. Memantine can paradoxically worsen hallucinations in a minority of patients — monitor and stop if this occurs.

Can I stop Admenta if it is not helping?

Discuss with the prescriber. If formal cognitive testing at 6 months shows no benefit and the patient has progressed clearly, memantine can be stopped. Unlike donepezil, memantine has no significant discontinuation syndrome — but a gradual taper over 1–2 weeks is still standard practice.

Is Admenta safe with my parent's blood pressure or heart medications?

Memantine is generally safe with most cardiovascular medications. There is no significant interaction with beta-blockers, ACE inhibitors, ARBs, calcium channel blockers, statins, or aspirin. Thiazide diuretics may slightly raise memantine levels — monitor for side effects but no dose adjustment is usually needed. Memantine causes a mild rise in BP in some patients — check BP at the 6-week and 3-month visits.

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