Donamem
Donamem (Donepezil + Memantine) — Sun Pharma fixed-combination cognitive-enhancer for moderate-severe Alzheimer’s. Dual-mechanism therapy targeting acetylcholine and glutamate systems.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
Quick Answer
Donamem — donepezil + memantine fixed combination (Sun Pharma). Combined cholinesterase inhibitor + NMDA antagonist for moderate-to-severe Alzheimer’s disease. Two complementary mechanisms in one tablet — modestly better cognitive and functional outcomes than either alone.
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Why combine them
Donepezil (cholinesterase inhibitor) and memantine (NMDA antagonist) target different neurotransmitter systems implicated in Alzheimer’s. Multiple trials (DOMINO-AD, Tariot 2004, Hartmann 2003) show that combination therapy produces small but clinically meaningful additional benefit on cognitive (SIB, MMSE) and functional (ADCS-ADL) measures in moderate-to-severe disease, compared with cholinesterase inhibitor alone. The fixed combination simplifies the regimen and improves adherence.
Dosing
Available as 5 mg + 5 mg or 10 mg + 5 mg (donepezil + memantine). Patients are typically titrated up on each component separately first (memantine 5 mg/week up to 10 mg BID; donepezil 5 mg → 10 mg after 4 weeks) before being switched to the fixed combination at the appropriate strength.
Take once daily in the evening. Renal-dose adjust the memantine component if CrCl <50 mL/min — a fixed-dose combination may not be appropriate; switch to separate components.
Side effects (combined profile)
- GI: nausea, vomiting, diarrhoea, anorexia, weight loss (donepezil component)
- CNS: insomnia, vivid dreams, dizziness, somnolence, headache (both)
- Cardiac: bradycardia, AV block (donepezil)
- Less common: hallucinations, confusion (memantine component, especially during titration)
Avoid concurrent anticholinergic drugs (oxybutynin, tolterodine, hyoscine, TCAs, first-gen antihistamines) — they oppose donepezil’s effect AND independently worsen cognition. For overactive bladder in dementia, prefer mirabegron.
Frequently Asked Questions
Should I start on the combination directly?
No — both drugs require slow titration to manage GI (donepezil) and CNS (memantine) side effects. Most clinicians titrate each separately first, then switch to the fixed combination once the patient is stable on the target doses.
What benefit does combination give over donepezil alone?
Modest additional benefit on cognitive and functional measures (typically 1-2 points on SIB or 0.5-1 point on ADCS-ADL) in moderate-severe disease. Effect size is small but clinically meaningful for some families.
What about side effects?
Stacked from both components: nausea, diarrhoea, headache (donepezil); dizziness, constipation, headache (memantine). Most are dose-limiting only at high doses or with rapid titration.
Renal failure?
The memantine component is renally cleared. If CrCl <50 mL/min, switch to separate components rather than the fixed combination so memantine can be dose-reduced independently.
When should combination be stopped?
Reassess at 6-12 month intervals. Stop in advanced disease when goals shift to comfort-focused care, or if side effects (especially weight loss, syncope) outweigh perceived benefit.
Can it slow disease?
No — both drugs are symptomatic. They do not slow underlying neurodegeneration.
Drug interactions?
Donepezil component interacts with anticholinergics (which oppose its action) and bradycardic drugs. Memantine interacts with other NMDA antagonists and urinary alkalisers. See individual product pages for the full interaction lists.
What if a dose is missed?
Skip the missed dose and resume the normal schedule. If several days are missed, restart on separate components at the lower titration step to avoid side effects.
Can my loved one drive?
Stable patients on the target dose can usually drive. Initial titration may cause dizziness and somnolence — do not drive until stable. Driving fitness should be reassessed regularly as dementia progresses regardless of medication.
Is there a difference between the 5+5 and 10+5 strengths?
The 10+5 strength has the fully titrated donepezil dose (10 mg) plus the half memantine dose (5 mg). The fully titrated memantine target is 10 mg twice daily — so most patients on combination need either two of the 5+5 strengths or one 10+5 strength plus a separate evening 5 mg memantine. Confirm the regimen with the prescribing clinician.
Other Alzheimer’s & Dementia Medications
- Alzil — donepezil 5/10 mg monotherapy
- Donep — donepezil 5/10 mg
- Donecept — donepezil 5/10 mg — Cipla brand
- Nemdaa — memantine 5/10 mg monotherapy
- Ashvagandha — Ayurvedic adaptogen — adjunctive only, not substitute therapy
More options in Alzheimer's Treatment
Ranked by recent MedsBase order volume — what other customers in this category are picking.
| Strength | 5 mg+5 mg, 10 mg+5 mg |
|---|---|
| Quantity | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s |
| Pharma Form | Tablet/s |
| Manufacturer | Sun Pharma |
| Treatment | Alzheimer's Disease |
| Generic Brand | Donepezil + Memantine |
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