{"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\/el\/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;\">\u0393\u03c1\u03ae\u03b3\u03bf\u03c1\u03b7 \u03b1\u03c0\u03ac\u03bd\u03c4\u03b7\u03c3\u03b7<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Nemdaa<\/strong> \u2014 memantine 5\/10 mg (Intas Pharma). Low-affinity uncompetitive NMDA-receptor antagonist for moderate-to-severe Alzheimer&#8217;s disease. Often combined with a cholinesterase inhibitor (donepezil). Modest symptomatic benefit; renal-dose adjustment required.<\/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>\u0391\u03c5\u03c4\u03cc \u03c0\u03bf\u03c5 \u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03b5\u03c4\u03b5 \u03bc\u03b5 \u03c4\u03b7\u03bd MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>\u03c0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03b7\u03bc\u03ad\u03bd\u03bf \u03b1\u03c0\u03cc \u03c4\u03b7 WHO-GMP \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ae<\/li>\n<li>\u03a3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u03c3\u03b5 \u03b1\u03c0\u03bb\u03cc \u03c6\u03ac\u03ba\u03b5\u03bb\u03bf \u03c7\u03c9\u03c1\u03af\u03c2 \u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2<\/li>\n<li>\u03a0\u03b1\u03b3\u03ba\u03cc\u03c3\u03bc\u03b9\u03b1 \u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae<\/li>\n<li>\u0391\u03be\u03b9\u03bf\u03bb\u03bf\u03b3\u03ae\u03b8\u03b7\u03ba\u03b5 \u03b1\u03c0\u03cc 1,400+ \u03c0\u03b5\u03bb\u03ac\u03c4\u03b5\u03c2 (<a href=\"https:\/\/medsbase.com\/el\/reviews\/\">\u03b4\u03b9\u03b1\u03b2\u03ac\u03c3\u03c4\u03b5 \u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ad\u03c2<\/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>\u0395\u03b3\u03b3\u03cd\u03b7\u03c3\u03b7 \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2:<\/strong> \u03b1\u03bd \u03b7 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03c3\u03b1\u03c2 \u03b4\u03b5\u03bd \u03ad\u03c7\u03b5\u03b9 \u03c6\u03c4\u03ac\u03c3\u03b5\u03b9 \u03bc\u03ad\u03c3\u03b1 \u03c3\u03b5 20 \u03b5\u03c1\u03b3\u03ac\u03c3\u03b9\u03bc\u03b5\u03c2 \u03b7\u03bc\u03ad\u03c1\u03b5\u03c2 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd \u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae, \u03c4\u03b7\u03bd \u03b5\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03c5\u03bc\u03b5 \u03c7\u03c9\u03c1\u03af\u03c2 \u03c0\u03c1\u03cc\u03c3\u03b8\u03b5\u03c4\u03bf \u03ba\u03cc\u03c3\u03c4\u03bf\u03c2. <a href=\"https:\/\/medsbase.com\/el\/medsbase-re-shipment-assurance-policy\/\">\u0394\u03b9\u03b1\u03b2\u03ac\u03c3\u03c4\u03b5 \u03c4\u03b7\u03bd \u03c0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae<\/a>.<\/p>\n<h3>\u0393\u03b9\u03b1\u03c4\u03af \u03bd\u03b1 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03af\u03bb\u03b5\u03c4\u03b5 \u03b1\u03c0\u03cc \u03c4\u03b7 MedsBase<\/h3>\n<p>Nemdaa ships from a WHO-GMP certified manufacturer in plain packaging, billed through a regulated payment processor (the statement descriptor reads a regulated card-payment processor \u2014 never MedsBase or any medication name). Every order carries our 20-business-day Reshipment Assurance.<\/p>\n<h2>How memantine works<\/h2>\n<p>In Alzheimer&#8217;s, glutamate accumulates in the synaptic cleft and chronically over-activates NMDA receptors, contributing to excitotoxicity and cognitive decline. Memantine is a low-affinity uncompetitive NMDA antagonist \u2014 it blocks pathological tonic glutamate signalling without blocking the high-amplitude phasic signals needed for normal learning and memory. This selectivity is why it differs from older NMDA antagonists (ketamine, MK-801) which block all NMDA activity and are not tolerable as cognitive drugs.<\/p>\n<h2>Dosing \u2014 slow titration<\/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;\">\u0395\u03b2\u03b4\u03bf\u03bc\u03ac\u03b4\u03b1<\/th>\n<th style=\"padding:8px;border:1px solid #ddd;\">\u0394\u03cc\u03c3\u03b7<\/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 once daily (morning)<\/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 twice daily (morning + evening)<\/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 morning + 5 mg evening<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">4 onward<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">10 mg twice daily (target dose)<\/td>\n<\/tr>\n<\/table>\n<p>Slow titration minimises CNS side effects (dizziness, confusion, sedation). The XR formulation (28 mg once daily, where available) is also titrated weekly.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>\u03a0\u03c1\u03bf\u03c3\u03b1\u03c1\u03bc\u03bf\u03b3\u03ae \u03b4\u03cc\u03c3\u03b7\u03c2 \u03b3\u03b9\u03b1 \u03bd\u03b5\u03c6\u03c1\u03b9\u03ba\u03ae \u03b4\u03c5\u03c3\u03bb\u03b5\u03b9\u03c4\u03bf\u03c5\u03c1\u03b3\u03af\u03b1<\/strong><br \/>Memantine is renally cleared. Adjust dose by creatinine clearance:<br \/>\u2022 CrCl &gt;50 mL\/min: standard dosing (target 10 mg BID)<br \/>\u2022 CrCl 30-50 mL\/min: target 5 mg BID (10 mg\/day total)<br \/>\u2022 CrCl 5-29 mL\/min: 5 mg BID (specialist supervision)<br \/>\u2022 Dialysis: not well studied \u2014 use only if benefit clearly outweighs risk<\/div>\n<h2>\u03a0\u03b1\u03c1\u03b5\u03bd\u03ad\u03c1\u03b3\u03b5\u03b9\u03b5\u03c2<\/h2>\n<ul>\n<li>Common: dizziness, headache, constipation, somnolence, weight gain<\/li>\n<li>Less common: confusion, hallucinations, hypertension, agitation<\/li>\n<li>Rare: seizures, psychosis (usually pre-existing predisposition)<\/li>\n<\/ul>\n<h2>\u0391\u03bb\u03bb\u03b7\u03bb\u03b5\u03c0\u03b9\u03b4\u03c1\u03ac\u03c3\u03b5\u03b9\u03c2 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03c9\u03bd<\/h2>\n<ul>\n<li>Other NMDA antagonists (amantadine, ketamine, dextromethorphan): additive CNS effects \u2014 avoid<\/li>\n<li>Urinary alkalisers (sodium bicarbonate, acetazolamide): reduce renal clearance \u2014 monitor<\/li>\n<li>Hydrochlorothiazide: reduces hydrochlorothiazide levels by ~20% \u2014 usually not clinically significant<\/li>\n<li>Cimetidine, ranitidine, quinidine, nicotine: minor interactions via shared renal cation transport<\/li>\n<\/ul>\n<h2 id=\"faqs\">\u03a3\u03c5\u03c7\u03bd\u03ad\u03c2 \u0395\u03c1\u03c9\u03c4\u03ae\u03c3\u03b5\u03b9\u03c2<\/h2>\n<h3>When should memantine be added?<\/h3>\n<p>Memantine is approved for moderate-to-severe Alzheimer&#8217;s (typically MMSE \u226419 or after a clear functional plateau on donepezil alone). Combination donepezil + memantine in moderate-severe disease has additive benefit.<\/p>\n<h3>\u03a0\u03b1\u03c1\u03b5\u03bd\u03ad\u03c1\u03b3\u03b5\u03b9\u03b5\u03c2;<\/h3>\n<p>Generally well tolerated. Common: dizziness, headache, constipation, somnolence. Less common: hallucinations, agitation, confusion (usually transient). Slow titration helps.<\/p>\n<h3>Can it be combined with donepezil?<\/h3>\n<p>Yes \u2014 combination is standard for moderate-severe disease. The two drugs hit different neurotransmitter systems (acetylcholine vs glutamate) and have additive cognitive benefit without major drug interactions.<\/p>\n<h3>What about kidney function?<\/h3>\n<p>Memantine is renally cleared. Reduce dose if CrCl &lt;50 mL\/min. Always monitor renal function in older patients on long-term therapy.<\/p>\n<h3>Will it stop or slow disease?<\/h3>\n<p>No \u2014 memantine is symptomatic, not disease-modifying. It may slow functional decline modestly and reduce care-burden milestones, but does not change underlying neurodegeneration.<\/p>\n<h3>Off-label uses?<\/h3>\n<p>Memantine has been studied off-label for vascular dementia, OCD augmentation, neuropathic pain, alcohol use disorder, and migraine prophylaxis \u2014 evidence is mixed and most uses are research-only.<\/p>\n<h3>\u0391\u03bb\u03bb\u03b7\u03bb\u03b5\u03c0\u03b9\u03b4\u03c1\u03ac\u03c3\u03b5\u03b9\u03c2 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03c9\u03bd;<\/h3>\n<p>Few clinically significant interactions. Avoid combination with other NMDA antagonists (amantadine, ketamine, dextromethorphan) \u2014 additive CNS effects. Urinary alkalisers (sodium bicarbonate, acetazolamide) reduce memantine clearance and raise levels.<\/p>\n<h3>\u03a4\u03b9 \u03b3\u03af\u03bd\u03b5\u03c4\u03b1\u03b9 \u03b1\u03bd \u03be\u03b5\u03c7\u03ac\u03c3\u03b5\u03c4\u03b5 \u03bc\u03b9\u03b1 \u03b4\u03cc\u03c3\u03b7;<\/h3>\n<p>Skip the missed dose and continue the normal schedule. If several days are missed, restart at the lower starting dose and re-titrate to avoid CNS side effects.<\/p>\n<h3>\u03a0\u03cc\u03c4\u03b5 \u03c0\u03c1\u03ad\u03c0\u03b5\u03b9 \u03bd\u03b1 \u03b4\u03b9\u03b1\u03ba\u03bf\u03c0\u03b5\u03af;<\/h3>\n<p>Reassess every 6 months. Stop if no perceived benefit, if side effects outweigh benefit, or in late-stage disease where goals shift to comfort-focused care.<\/p>\n<h3>Can I drive?<\/h3>\n<p>Initial titration causes dizziness and somnolence in some patients \u2014 do not drive until stable on the maintenance dose. Most patients on stable therapy can drive without restriction.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Other Alzheimer&#8217;s &#038; Dementia Medications<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/el\/donamem\/\">Donamem<\/a> \u2014 donepezil + memantine fixed combo<\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/alzil\/\">Alzil<\/a> \u2014 donepezil 5\/10 mg<\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/donep\/\">Donep<\/a> \u2014 donepezil 5\/10 mg \u2014 Alkem brand<\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/donecept\/\">Donecept<\/a> \u2014 donepezil 5\/10 mg \u2014 Cipla brand<\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/ashvagandha\/\">Ashvagandha<\/a> \u2014 Ayurvedic adaptogen \u2014 adjunctive only, NOT a substitute for prescription dementia therapy<\/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>\u0399\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae \u0391\u03c0\u03bf\u03c0\u03bf\u03af\u03b7\u03c3\u03b7 \u0395\u03c5\u03b8\u03c5\u03bd\u03ce\u03bd:<\/strong> \u0391\u03c5\u03c4\u03ae \u03b7 \u03c3\u03b5\u03bb\u03af\u03b4\u03b1 \u03c0\u03b1\u03c1\u03ad\u03c7\u03b5\u03b9 \u03bc\u03cc\u03bd\u03bf \u03c0\u03bb\u03b7\u03c1\u03bf\u03c6\u03bf\u03c1\u03af\u03b5\u03c2 \u03ba\u03b1\u03b9 \u03b4\u03b5\u03bd \u03b1\u03c0\u03bf\u03c4\u03b5\u03bb\u03b5\u03af \u03c5\u03c0\u03bf\u03ba\u03b1\u03c4\u03ac\u03c3\u03c4\u03b1\u03c4\u03bf \u03b9\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae\u03c2 \u03c3\u03c5\u03bc\u03b2\u03bf\u03c5\u03bb\u03ae\u03c2 \u03b1\u03c0\u03cc \u03b5\u03b9\u03b4\u03b9\u03ba\u03cc. \u03a3\u03c5\u03b6\u03b7\u03c4\u03ae\u03c3\u03c4\u03b5 \u03ba\u03ac\u03b8\u03b5 \u03bd\u03ad\u03bf \u03c6\u03ac\u03c1\u03bc\u03b1\u03ba\u03bf \u03bc\u03b5 \u03c4\u03bf\u03bd \u03b3\u03b9\u03b1\u03c4\u03c1\u03cc \u03ae \u03c4\u03bf\u03bd \u03c6\u03b1\u03c1\u03bc\u03b1\u03ba\u03bf\u03c0\u03bf\u03b9\u03cc \u03c3\u03b1\u03c2.<\/div>","protected":false},"excerpt":{"rendered":"<p>Nemdaa (Memantine 5\/10 mg) \u2014 Intas Pharma uncompetitive NMDA-receptor antagonist for moderate-severe Alzheimer&#8217;s disease. Slow weekly titration to 10 mg twice daily; renal-dose-adjusted.<\/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\/el\/wp-json\/wp\/v2\/product\/54711","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/comments?post=54711"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/media\/54712"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/media?parent=54711"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_brand?post=54711"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_cat?post=54711"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_tag?post=54711"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}