Namzaric (Memantine and Donepezil) - Oral

What Is Namzaric?

Namzaric is an oral medication used to treat moderate to severe dementia in adults with Alzheimer's. Namzaric contains two drugs—memantine hydrochloride and donepezil hydrochloride.

Memantine belongs to a group of drugs called NMDA receptor antagonists. It works by blocking abnormal signaling in the brain. Donepezil is an acetylcholinesterase inhibitor. It works by increasing levels of a natural brain chemical called acetylcholine. Researchers believe that low levels of acetylcholine contribute to Alzheimer's symptoms.

What Is Namzaric Used For?

Namzaric is an oral medication used to treat moderate to severe dementia in adults with Alzheimer's.

Alzheimer's disease affects about 1 in 9 people age 65 and older in the United States and is the most common cause of dementia. Alzheimer's disease is a progressive brain disorder, which means it gets worse over time. Early symptoms may include trouble remembering recent conversations, names, or events; lack of interest; and depression. As the disease progresses, symptoms may include:

• Trouble communicating
• Confusion
• Poor judgment
• Trouble bathing, dressing, or going to the bathroom
• Incontinence
• Agitation and suspiciousness
• Behavioral changes
• Difficulty speaking, swallowing, and walking

While there is no cure for Alzheimer's, medications like Namzaric may help improve symptoms or slow the progression of the disease, but they will not prevent symptoms from getting worse in the future.

How to Take Namzaric

Namzaric is taken once daily at bedtime, with or without food. The capsules should be swallowed whole without dividing, crushing, or chewing. Namzaric may be opened and sprinkled on applesauce for people who have difficulty swallowing capsules. Swallow the applesauce mixture without chewing.

Before starting Namzaric, your healthcare provider will prescribe Aricept (donepezil)—one of the medications in Namzaric. You'll need to be stable on 10 milligrams (mg) of Aricept before switching to Namzaric.

Storage

Store Namzaric at room temperature in a tightly closed container protected from light. Do not store it in the bathroom. Keep Namzaric and all of your medicines in a safe location, out of the reach of children and pets.

What Are the Side Effects of Namzaric?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of Namzaric may include but may not be limited to:

• Headache
  
• Diarrhea
• Dizziness
  
• Loss of appetite
• Bruising
  

Severe Side Effects

Contact your healthcare provider immediately if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Severe side effects of Namzaric may include but may not be limited to:

• Muscle problems during surgery. Be sure to inform your surgeon about all your medicines, including Namzaric.
• A slow heart rate and fainting, especially in people with heart problems
• Stomach ulcers and bleeding in the stomach or intestines. People who take aspirin or NSAIDs or have had an ulcer in the past are at an increased risk. Tell your healthcare provider if you develop bloody vomiting or vomit that looks like coffee grounds, blood in your stool, stools that look black or tarry, or abdominal pain.
• Nausea and vomiting that last for several weeks
• Trouble urinating
• Seizures
• Worsening lung problems in people with asthma or other lung conditions
  

Dosage: How Much Namzaric Should I Take?

Modifications

The following modifications should be kept in mind when using Namzaric:

Severe allergic reaction: Avoid using Namzaric if you have a known allergy to it or any of its ingredients, including Aricept (donepezil) and Namenda (memantine). Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: In animal studies, Namzaric was found to have harmful effects on the fetus. We don't know enough about the safety and effectiveness of Namzaric in pregnant people and their unborn fetuses. Let your healthcare provider know if you're pregnant or plan to become pregnant, and discuss the benefits and risks of taking Namzaric during your pregnancy.

Breastfeeding: We don't know enough about the safety of Namzaric in human breast milk and nursing babies. Talk with your healthcare provider if you plan to breastfeed, and discuss the benefits and risks of taking Namzaric while nursing and the different ways to feed your baby.

Adults over 65: Most participants in the clinical trials for Namzaric were older than 65. No significant safety or side effect differences were found in people over 65 versus younger adults.

Children: Namzaric is not approved to treat children.

Kidney problems: Individuals with kidney problems may not be able to clear medication from their bodies as easily. This means the medicine stays in the body longer and can have increased side effects. For this reason, your healthcare provider will likely not prescribe Namzaric beyond a specific dose if you have severe kidney impairment.

Administration modifications: Namzaric may be opened and sprinkled on applesauce for people who have difficulty swallowing capsules. The applesauce mixture should be swallowed without chewing. Be sure to empty the entire contents of the Namaric capsule onto the applesauce. Do not divide the dose.

Missed Dose

If you accidentally forgot your Namzaric dose, take the following dose at your next scheduled dosing time. Don't double up or take extra to make up for the missed dose.

Try to help yourself remember to keep your appointments and take your medication routinely. If you miss too many doses, Namzaric might be less effective at treating your condition.

Overdose: What Happens If I Take Too Much Namzaric?

The symptoms of a Namzaric overdose may include but are not limited to:

• Agitation
• Weakness
• Nausea
• Vomiting
• Excessive sweating or salivation
• Slowed heart rate
• Confusion
• Dizziness
• Increased or decreased blood pressure
• Vertigo
• Tiredness
  
• Restlessness
• Slowed movements
• Trouble walking
• Hallucinations
• Psychosis
• Slowed breathing
• Seizures
• Coma
  

If you think you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.

Precautions

What Are Reasons I Shouldn’t Take Namzaric?

Do not take Namzaric if you:

• Are allergic to Namzaric or any of its ingredients, including Aricept (donepezil) and Namenda (memantine), or medicines that contain piperidines.

What Other Medications Interact With Namzaric?

Use caution when taking Namzaric with the following medications:

• Diamox (acetazolamide)
• Sodium bicarbonate
• Osmolex ER (amantadine)
• Ketamine
• Robitussin (dextromethorphan)
• Certain HIV medications
• Biaxin (clarithromycin) 
• Nizoral (ketoconazole) 
• Nefazodone 
• Noxafil (posaconazole)
• Sporanox (itraconazole)
• Vfend (voriconazole)
• Wellbutrin (bupropion)
• Prozac (fluoxetine)
• Paxil (paroxetine)
• Quinidine
• Tegretol (carbamazepine)
• Phenobarbital
• Dilantin (phenytoin)
• Mysoline (primidone)
• Rifadin (rifampin)
• Elavil (amitriptyline)
• Atropisol (atropine)
• Clozaril (clozapine)
• Bentyl (dicyclomine)
• Silenor (doxepin)
• Thioridazine
• Detrol (tolterodine)
• Chlorpromazine
• Benadryl (diphenhydramine)
• Pamelor (nortriptyline)
• Zyprexa (olanzapine)
• Ditropan XL (oxybutynin)
• Quelicin (succinylcholine) and other paralytic medications used during surgery
• Duvoid (bethanechol)

Other medications may interact with Namzaric. Inform your healthcare provider about all the medicines you take, including over-the-counter, nonprescription products, vitamins, and herbal supplements.

What Medications Are Similar?

Namzaric is the only medication that combines two Alzheimer's medicines into one capsule. Namzaric contains donepezil (an acetylcholinesterase inhibitor) and memantine (an NMDA receptor antagonist). Other medicines in these drug classes include:

Acetylcholinesterase inhibitors:

• Aricept (donepezil)
• Razadyne ER (galantamine)
• Exelon (rivastigmine)

NMDA receptor antagonists:

• Namenda (memantine)

Choosing a treatment strategy will depend on your symptoms, other medical conditions, and side effects. You and your healthcare provider will work together to select the best option for you.

How Can I Stay Healthy While Taking Namzaric?

If a loved one has started taking Namzaric, the symptoms of Alzheimer's disease have likely begun to impact their quality of life. While caring for a loved one with Alzheimer's can be challenging, there are ways to help make your day-to-day life easier. Refer below for some general tips:

• Establish a daily routine, but be flexible. Specific tasks may take longer than they used to.
• Limit napping during the day. This can help prevent confusing day for night.
• Install safety measures around the house as needed, including protective covers on the stove knobs, locks on cabinets that contain anything dangerous, and electrical outlet safety plugs.
• Ensure the house is tidy and free of any clutter that could pose a trip hazard.
  
• Consider joining a dementia caregiver support group that can help provide advice, resources, and coping strategies.
• Ask for help. Being a caregiver can sometimes feel overwhelming, but asking for help is essential for maintaining your well-being.