Universal reference book for medicines
Product name: MARUXA (MARUXA)

Active substance: memantine

Type: Glutamate NMDA receptor blocker.
The drug for the treatment of dementia
Manufacturer: КРКА-РУС (Russia)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
A remedy for the treatment of dementia.
It is a noncompetitive antagonist of glutamate NMDA-receptors (including in black substance), thereby reducing the excessive stimulating effect of cortical glutamate neurons on neostriatum, which develops against the background of insufficient dopamine excretion. Reducing the entry of Ca 2+ into neurons, reduces the possibility of their destruction.
Has nootropic, cerebrozodilating, antihypoxic and psychostimulating action.

Improves weakened memory, increases the ability to concentrate, reduces fatigue and symptoms of depression, reduces spasticity of skeletal muscles, caused by diseases or brain damage.

PHARMACOKINETICS
After ingestion quickly and completely absorbed from the digestive tract.
C max is achieved in 3-8 hours. Binding to plasma proteins - 45%. When taken at a dose of 20 mg / day, C ss is reached from 70 to 150 ng / ml. V d is 10 l / kg. Partially metabolized in the liver. It is excreted by the kidneys. T 1/2 is - 60-100 hours; clearance is 170 ml / min / 1.73 m 2 .
INDICATIONS
Dementia of moderate and severe degree in Alzheimer's disease.

DOSING MODE
When administered orally, the initial dose for adults is 5 mg / day.
In the future, the dose can be increased weekly by 5 mg. The average maintenance dose is 10-20 mg / day. The maximum dose is 20 mg / day.
SIDE EFFECT
From the nervous system: dizziness, headache, drowsiness, gait disturbance, confusion, hallucinations, convulsions, psychosis, increased excitability.

From the digestive system: constipation, vomiting, nausea, pancreatitis.

From the cardiovascular system: increased blood pressure, venous thrombosis, thromboembolism.

On the part of the body as a whole: fungal infections, general weakness, increased fatigue, allergic reactions.



CONTRAINDICATIONS
Severe hepatic insufficiency;
pregnancy; lactation period (breastfeeding); children and adolescents under 18 years of age (efficacy and safety of the drug not studied);increased sensitivity to memantine.
PREGNANCY AND LACTATION
Contraindicated in pregnancy and lactation (breastfeeding).

APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in renal failure.
In case of violations of kidney function, the dose of memantine should be reduced.
SPECIAL INSTRUCTIONS
With caution should be used in patients with epilepsy, kidney failure, thyrotoxicosis, history of seizures, hypertension, myocardial infarction in history, heart failure.

In case of violations of kidney function, the dose of memantine should be reduced.

DRUG INTERACTION
With simultaneous use memantine can reduce the effects of barbiturates and neuroleptics.

The effects of baclofen and dantrolene may change under the influence of memantine (this combination may require dosage adjustment).

Effects of levodopa, dopamine receptor agonists and anticholinergic agents are enhanced by the simultaneous use of NMDA receptor antagonists.

Due to the fact that memantine and amantadine are antagonists of NMDA receptors, simultaneous application in connection with the risk of toxic development should be avoided.

Potentially toxic are also combinations of memantine with ketamine, dextromethorphan and phenytoin.

For the transport of amantadine, cimetidine, ranitidine, quinidine, quinine and nicotine, the same renal cation system is used in the body, which can cause the interaction of these drugs with memantine, leading to an increase in its concentration in the blood plasma.

With simultaneous use of memantine can cause a decrease in the concentration of hydrochlorothiazide in the blood serum.

When used simultaneously with warfarin and other indirect anticoagulants, careful monitoring of prothrombin time and INR is required.

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