{"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\/ro\/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;\">R\u0103spuns rapid<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Nemdaa<\/strong> \u2014 memantine 5\/10 mg (Intas Pharma). Antagonist necompetitiv de afinitate sc\u0103zut\u0103 al receptorului NMDA pentru boala Alzheimer moderat\u0103 p\u00e2n\u0103 la sever\u0103. Adesea combinat cu un inhibitor de colinesteraz\u0103 (donepezil). Beneficiu simptomatic modest; necesit\u0103 ajustare a dozei la pacien\u021bii cu insuficien\u021b\u0103 renal\u0103.<\/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>Ce beneficii ofer\u0103 MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>produc\u0103tor certificat WHO-GMP<\/li>\n<li>Ambalaj discret \u00een plic simplu<\/li>\n<li>Livrare \u00een toat\u0103 lumea<\/li>\n<li>Evaluat de peste 1.400 de clien\u021bi (<a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">cite\u0219te recenziile<\/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>Garan\u021bia de retransmitere:<\/strong> dac\u0103 comanda dvs. nu a ajuns \u00een 20 de zile lucr\u0103toare de la expediere, o retransmitem f\u0103r\u0103 costuri suplimentare. <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\">Cite\u0219te politica<\/a>.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Nemdaa este expediat de la un produc\u0103tor certificat WHO-GMP \u00een ambalaj neutru, facturat prin procesor de plat\u0103 reglementat (descrierea extrasului de cont indic\u0103 un procesor de plat\u0103 cu card reglementat \u2014 niciodat\u0103 MedsBase sau nume de medicament). Fiecare comand\u0103 beneficiaz\u0103 de Garantia noastr\u0103 de Retrimitere \u00een 20 de zile lucr\u0103toare.<\/p>\n<h2>Cum ac\u021bioneaz\u0103 memantina<\/h2>\n<p>\u00cen boala Alzheimer, glutamatul se acumuleaz\u0103 \u00een fanta sinaptic\u0103 \u0219i supraactiveaz\u0103 cronic receptorii NMDA, contribuind la excitotoxicitate \u0219i declin cognitiv. Memantina este un antagonist necompetitiv de afinitate sc\u0103zut\u0103 al receptorului NMDA \u2014 blocheaz\u0103 semnalizarea tonic\u0103 patologic\u0103 a glutamatului f\u0103r\u0103 a bloca semnalele fazice de amplitudine mare necesare pentru \u00eenv\u0103\u021bare \u0219i memorie normal\u0103. Aceast\u0103 selectivitate o diferen\u021biaz\u0103 de antagoni\u0219tii NMDA mai vechi (ketamina, MK-801) care blocheaz\u0103 toat\u0103 activitatea NMDA \u0219i nu sunt tolerabili ca medicamente cognitive.<\/p>\n<h2>Doza\u021biere \u2014 titrare lent\u0103<\/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;\">S\u0103pt\u0103m\u00e2na<\/th>\n<th style=\"padding:8px;border:1px solid #ddd;\">Doza<\/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 o dat\u0103 pe zi (diminea\u021ba)<\/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 de dou\u0103 ori pe zi (diminea\u021ba + seara)<\/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 diminea\u021ba + 5 mg seara<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">4 \u00een continuare<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">10 mg de dou\u0103 ori pe zi (doza \u021bint\u0103)<\/td>\n<\/tr>\n<\/table>\n<p>Titrare lent\u0103 minimizeaz\u0103 efectele secundare ale SNC (ame\u021beli, confuzie, sedare). Forma cu eliberare prelungit\u0103 (28 mg o dat\u0103 pe zi, unde este disponibil\u0103) este de asemenea titrat\u0103 s\u0103pt\u0103m\u00e2nal.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Ajustarea dozei la pacien\u021bii cu insuficien\u021b\u0103 renal\u0103<\/strong><br \/>Memantina este eliminat\u0103 renal. Ajusta\u021bi doza \u00een func\u021bie de clearance-ul de creatinin\u0103:<br \/>\u2022 CrCl &gt;50 mL\/min: doza standard (\u021bint\u0103 10 mg de dou\u0103 ori pe zi)<br \/>\u2022 CrCl 30-50 mL\/min: doz\u0103 \u021bint\u0103 5 mg de 2 ori pe zi (total 10 mg\/zi)<br \/>\u2022 CrCl 5-29 mL\/min: 5 mg de 2 ori pe zi (sub supraveghere specializat\u0103)<br \/>\u2022 Dializ\u0103: nu a fost suficient studiat \u2014 utiliza\u021bi doar dac\u0103 beneficiul dep\u0103\u0219e\u0219te clar riscul<\/div>\n<h2>Efecte secundare<\/h2>\n<ul>\n<li>Frecvente: ame\u021beli, cefalee, constipa\u021bie, somnolen\u021b\u0103, cre\u0219tere \u00een greutate<\/li>\n<li>Mai pu\u021bin frecvente: confuzie, halucina\u021bii, hipertensiune, agita\u021bie<\/li>\n<li>Rare: convulsii, psihoz\u0103 (de obicei la pacien\u021bi cu predispozi\u021bie preexistent\u0103)<\/li>\n<\/ul>\n<h2>Interac\u021biuni medicamentoase<\/h2>\n<ul>\n<li>Al\u021bi antagoni\u0219ti NMDA (amantadin\u0103, ketamin\u0103, dextrometorfan): efecte aditive pe SNC \u2014 evita\u021bi<\/li>\n<li>Alcalinizante urinare (bicarbonat de sodiu, acetazolamid\u0103): reduc clearance-ul renal \u2014 monitoriza\u021bi<\/li>\n<li>Hidroclorotiazid\u0103: reduce nivelurile de hidroclorotiazid\u0103 cu ~20% \u2014 de obicei f\u0103r\u0103 semnifica\u021bie clinic\u0103<\/li>\n<li>Cimetidin\u0103, ranitidin\u0103, chinidin\u0103, nicotin\u0103: interac\u021biuni minore prin transportul renal comun de cationi<\/li>\n<\/ul>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3>C\u00e2nd ar trebui ad\u0103ugat memantina?<\/h3>\n<p>Memantina este aprobat\u0103 pentru Alzheimer moderat-sever (de obicei MMSE \u226419 sau dup\u0103 un platou func\u021bional clar sub donepezil singur). Combina\u021bia donepezil + memantin\u0103 \u00een boal\u0103 moderat-sever\u0103 are beneficii aditive.<\/p>\n<h3>Efecte secundare?<\/h3>\n<p>\u00cen general, bine tolerat\u0103. Efecte frecvente: ame\u021beli, cefalee, constipa\u021bie, somnolen\u021b\u0103. Mai pu\u021bin frecvente: halucina\u021bii, agita\u021bie, confuzie (de obicei tranzitorii). Titrarea lent\u0103 ajut\u0103.<\/p>\n<h3>Poate fi combinat\u0103 cu donepezil?<\/h3>\n<p>Da \u2014 combina\u021bia este standard pentru boala moderat-sever\u0103. Cele dou\u0103 medicamente ac\u021bioneaz\u0103 pe sisteme diferite de neurotransmi\u021b\u0103tori (acetilcolina vs glutamat) \u0219i au beneficii cognitive aditive f\u0103r\u0103 interac\u021biuni medicamentoase majore.<\/p>\n<h3>Ce se \u00eent\u00e2mpl\u0103 cu func\u021bia renal\u0103?<\/h3>\n<p>Memantina este eliminat\u0103 renal. Reduce\u021bi doza dac\u0103 CrCl &lt;50 mL\/min. Monitoriza\u021bi \u00eentotdeauna func\u021bia renal\u0103 la pacien\u021bii \u00een v\u00e2rst\u0103 sub terapie pe termen lung.<\/p>\n<h3>Opre\u0219te sau \u00eencetine\u0219te boala?<\/h3>\n<p>Nu \u2014 memantina are efect simptomatic, nu modific\u0103 evolu\u021bia bolii. Poate \u00eencetini modest declinul func\u021bional \u0219i reduce reperele de povar\u0103 \u00eengrijitorilor, dar nu schimb\u0103 neurodegenera\u021bia subiacent\u0103.<\/p>\n<h3>Utiliz\u0103ri off-label?<\/h3>\n<p>Memantina a fost studiat\u0103 off-label pentru demen\u021b\u0103 vascular\u0103, augmentare TOC, durere neuropatic\u0103, tulburare de consum de alcool \u0219i profilaxie migrene \u2014 dovezile sunt mixte \u0219i majoritatea utiliz\u0103rilor sunt doar \u00een cercetare.<\/p>\n<h3>Interac\u021biuni medicamentoase?<\/h3>\n<p>Pu\u021bine interac\u021biuni clinic semnificative. Evita\u021bi combina\u021bia cu al\u021bi antagoni\u0219ti NMDA (amantadin\u0103, ketamin\u0103, dextrometorfan) \u2014 efecte CNS aditive. Alcalinizantele urinare (bicarbonat de sodiu, acetazolamid\u0103) reduc clearance-ul memantinei \u0219i cresc nivelurile.<\/p>\n<h3>Ce se \u00eent\u00e2mpl\u0103 dac\u0103 uita\u021bi o doz\u0103?<\/h3>\n<p>Omite\u021bi doza ratat\u0103 \u0219i continua\u021bi programul normal. Dac\u0103 au fost ratate mai multe zile, reporni\u021bi la doza ini\u021bial\u0103 mai mic\u0103 \u0219i retitra\u021bi pentru a evita efectele adverse CNS.<\/p>\n<h3>C\u00e2nd ar trebui oprit?<\/h3>\n<p>Reevalua\u021bi la fiecare 6 luni. Opri\u021bi dac\u0103 nu se observ\u0103 beneficii, dac\u0103 efectele adverse dep\u0103\u0219esc beneficiile sau \u00een stadiile tardive ale bolii c\u00e2nd obiectivele se orienteaz\u0103 spre \u00eengrijire paliativ\u0103.<\/p>\n<h3>Pot conduce?<\/h3>\n<p>Titrarea ini\u021bial\u0103 poate provoca ame\u021beli \u0219i somnolen\u021b\u0103 la unii pacien\u021bi \u2014 nu conduce\u021bi p\u00e2n\u0103 c\u00e2nd v\u0103 stabili\u021bi pe doza de \u00eentre\u021binere. Majoritatea pacien\u021bilor cu terapie stabil\u0103 pot conduce f\u0103r\u0103 restric\u021bii.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Alte medicamente pentru Alzheimer \u0219i demen\u021b\u0103<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/donamem\/\">Donamem<\/a> \u2014 combina\u021bie fix\u0103 de donepezil + memantin\u0103<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/alzil\/\">Alzil<\/a> \u2014 donepezil 5\/10 mg<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/donep\/\">Donep<\/a> \u2014 donepezil 5\/10 mg \u2014 marca Alkem<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/donecept\/\">Donecept<\/a> \u2014 donepezil 5\/10 mg \u2014 marca Cipla<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/ashvagandha\/\">Ashvagandha<\/a> \u2014 adaptogen ayurvedic \u2014 doar adjunct, NU \u00eenlocuie\u0219te terapia de prescrip\u021bie pentru demen\u021b\u0103<\/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>Disclaimer medical:<\/strong> Aceast\u0103 pagin\u0103 este doar informativ\u0103 \u0219i nu \u00eenlocuie\u0219te sfatul medical al unui clinician calificat. Discuta\u021bi orice medicament nou cu medicul sau farmacistul dumneavoastr\u0103.<\/div>","protected":false},"excerpt":{"rendered":"<p>Nemdaa (Memantine 5\/10 mg) \u2014 Intas Pharma antagonist necompetitiv al receptorului NMDA pentru Alzheimer moderat-sever. Titrare lent\u0103 s\u0103pt\u0103m\u00e2nal\u0103 p\u00e2n\u0103 la 10 mg de dou\u0103 ori pe zi; ajustare doz\u0103 la pacien\u021bii cu insuficien\u021b\u0103 renal\u0103.<\/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\/ro\/wp-json\/wp\/v2\/product\/54711","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=54711"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/54712"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=54711"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=54711"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=54711"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=54711"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}