Galantamine Hydrobromide overview
Galantamine hydrobromide is a prescription drug used to treat dementia of Alzheimer’s disease. Galantamine was initially extracted from the snowdrop plant Galantus spp. The galantamine supplement is however a tertiary alkaloid which is chemically synthesized.
Although the cause of Alzheimer’s disorder is not well understood, it is known that people suffering from Alzheimer’s have low levels of the chemical acetylcholine in their brains. Acetylcholine is linked to cognitive function including memory, learning and communication among others. A decrease in this chemical (acetylcholine) has been associated with dementia of Alzheimer’s disease.
Galantamine benefits patients of Alzheimer’s disease due to its dual mechanism of action. It works by increasing acetylcholine levels in two ways. One is by preventing the breakdown of acetylcholine and the other is through allosteric modulation of nicotinic acetylcholine receptors. This two processes help increase the amount of the enzyme, acetylcholine.
While it may alleviate the symptoms of Alzheimer’s disease, galantamine hydrobromide is not a complete cure of Alzheimer’s disorder since it does not affect the underlying cause of the disease.
Apart from galantamine benefits of treating symptoms of Alzheimer’s disease, galantamine has been associated with lucid dreaming. Galantamine and lucid dreaming is an association that has been reported by individual users. To achieve this galantamine is taken some time in between your sleep for instance after 30 minutes of sleep. Some health care providers will encourage galantamine and lucid dreaming benefits through monitored schedule to avoid unnecessary side effects.
Galantamine supplement occur in tablet forms, oral solution and an extended-release capsule. It is usually taken with meals and drinking plenty of water to avoid unwanted side effects.
The common galantamine side effects include nausea, vomiting, headache, stomach discomfort or pain, muscle weakness, dizziness, drowsiness, and diarrhea. These galantamine hydrobromide side effects are usually mild and occur when you start taking this medication. They may disappear with time, however if they do not go away consult your doctor. There are also some uncommon but serious side effects that may occur such as trouble breathing, chest pain, severe stomach pain, trouble urinating, seizures, fainting among others.
Galantamine Hydrobromide
（1）What is Galantamine Hydrobromide?
Galantamine hydrobromide is a prescription drug used to treat mild or moderate dementia associated with Alzheimer’s disease. Alzheimer’s disease is a brain disorder that usually destroys the memory and thinking capability, learning, communication and ability to carry out daily tasks.
The galantamine hydrobromide medications may not treat progressed Alzheimer’s disorder but can be used along other Alzheimer’s drugs.
It occurs in three main forms with different strengths. The galantamine forms are oral solution, tablets and an extended-release capsules.
（2）Why is it used? who should take this medication?
Galantamine hydrobromide is used to treat mild to moderate symptoms of Alzheimer’s disease. Galantamine hydrobromide is not indicated for cure of Alzheimer’s disorder because it does not influence the underlying degenerative process of the disease.
Galantamine hydrobromide is indicated for use by people with mild to moderate symptoms of Alzheimer’s disease.
（3）How does it work?
Galantamine is in a class of drugs called acetylcholinesterase inhibitors.
Galantamine works to increase the amount of the enzyme, acetylcholine in two ways. First it acts as a reversible and competitive acetylcholinesterase inhibitor thus preventing the breakdown of acetylcholine in the brain. Secondly, it also stimulates the nicotinic receptors in the brain to release more acetylcholine.
This raises the amounts of acetylcholine in the brain, which may help reduce the symptoms associated with dementia.
Galantamine can help enhance the ability to think and form memory as well as slow the loss of cognitive function in patients of Alzheimer’s disease.
Galantamine Hydrobromide benefits on Alzheimer’s disease
Alzheimer’s disease causes the brain cells to degenerate and eventually to die. The actual cause is not well known but this progressive disease leads to reduced cognitive function such as memory, learning, thinking and ability to perform daily tasks. What is known about patients of Alzheimer’s disease is the low level of the chemical acetylcholine.
Galantamine uses in treating the symptoms of dementia associated with Alzheimer’s disease occur due to its dual mode of action. it increases the level of acetylcholine, a key enzyme in cognitive enhancement. Galantamine acts as a reversible and competitive acetylcholinesterase inhibitor thus prevent the breakdown of acetylcholine. It also stimulates the nicotinic receptors to release more acetylcholine.
Other Potential Benefits
(1) Antioxidant Surname
Oxidative stress is known to be the cause of many degenerative disorders such as Parkinson’s disease, Alzheimer’s disease, diabetes, among others. It occurs naturally with age but when there is an imbalance between the free radicals and antioxidants, tissue damage may occur.
Galantamine is known to scavenge reactive oxygen species and offers protection to the neurons by preventing neurons damage by oxidative stress. Galantamine can also lower the overproduction of reactive oxygen species by increasing the level of acetylcholine.
(2) Antibacterial
Galantamine exhibits antibacterial activity.
How to take this medication?
i. Before taking Galantamine hydrobromide
As with other medications it is prudent to take the necessary precautions before taking galantamine hydrobromide.
Let your doctor know whether you are allergic to galantamine or any of its inactive ingredients.
Disclose all medications you are currently taking including prescribed drugs, over-the-counter medicines, herbal drugs or any natural health products.
It is advisable to inform your doctor of other conditions you are suffering from including;
- heart disease
- Liver disorders,
- Asthma,
- Kidney problems,
- Stomach ulcers,
- Acute abdominal pain,
- Seizures,
- Enlarged prostate,
- A recent operation especially on stomach or bladder.
Your health care provider should be informed whether you are pregnant or plan to get pregnant and whether you are breastfeeding. In case you get pregnant while taking galantamine supplement, you should talk to your doctor soonest.
It is important to tell your doctor that you are taking galantamine before any surgery including dental surgery.
Galantamine hydrobromide effects include drowsiness. You should hence avoid driving and operating machinery.
Taking galantamine and alcohol could increase the galantamine hydrobromide effects of drowsiness.
ii. Dosage recommended
(1) Dementia caused by Alzheimer’s disease
Galantamine hydrobromide for treating Alzheimer’s disease occur in generic form as well as the galantamine brand names such as Razadyne formerly known as Reminyl.
Galantamine hydrobromide occurs in three forms with different strengths. The oral tablet is available in 4 mg, 8 mg and 12 mg tablets. The oral solution is sold in a concentration of 4mg/ml and in most cases in 100 ml bottle. The oral extended-release capsule is available in 8 mg, 16 mg and 24 mg tablets.
While both oral tablet and oral solution are taken twice daily the oral extended-release capsule is taken once daily.
The starting galantamine dosage for the conventional forms (oral tablet and oral solution) is 4 mg twice daily. The dose should be taken with your morning and evening meals.
For the extended-release capsule the recommended initial dose is 8 mg daily taken with the morning meal. The extended-release capsule should be taken whole to enable slow release of the medication throughout the day. Therefore, do not crush or cut the capsule.
For a maintenance dosage depending on your tolerability to galantamine in the conventional form should be taken at 4 mg or 6 mg twice daily and an increase of 4 mg every 12 hours at least 4 weeks’ interval.
The extended-release capsule should be maintained at 16-24 mg daily and an increase of 8 mg at 4 weeks’ intervals.
Some important consideration when taking galantamine
Always take galantamine with your meals and with plenty of water. This will help avoid the unwanted galantamine side effects.
It is advisable to take the recommended galantamine dosage at about the same time every day. If you miss a dose, take it as soon as you remember if the next dose is not near. Otherwise skip the dose and continue with your regular schedule. However, if you miss your dose for 3 consecutive days, call your medical practitioner who may advise you to start over your dose.
Depending on the intended purpose, your doctor may adjust your doses accordingly by increasing it at a minimum of 4 weeks’ interval. Do not adjust your galantamine dosage for yourself.
If you are given the extended-release capsule, be sure to swallow it whole without chewing or crushing it. This is because the tablet is modified to release the drug slowly throughout the day.
For the oral solution prescription, always follow the advice given and only add the drug to a non-alcoholic drink which should be taken right away.
(2) Adult Dosage (ages 18 years and older)
The extended-release capsule has an initial dosage of 8 mg taken once daily in the morning. Your health care provider may adjust your dose by increasing it with 8 mg daily after a minimum of 4 weeks. For maintenance you should take 16-24 mg daily as advised by your doctor.
For the fast release doses, the start dose is 4 mg taken twice daily with meals hence 8 mg per day. The dose may be increased by your doctor by 4 mg daily after a minimum of 4 weeks’ interval.
(3) Child Dosage (ages 0-17 years)
Galantamine hydrobromide effects are not studied in children (ages 0-17 years), it should hence only be used with medical professionals advise.
iii. What to do if an overdose is taken?
If you or the patients you are monitoring takes too much of the galantamine dose, you should call your doctor or poison control center immediately. You may as well go to the nearest emergency unit soonest.
The common symptoms associated with galantamine overdose are severe nausea, sweating, severe stomach cramps trouble breathing, muscles twitching or weakness, seizures, fainting, irregular heartbeat and difficulty when urinating.
You doctor may give you some drugs such as atropine to reverse the galantamine side effects associated with overdosing.
What are side effects associated with using Galantamine hydrobromide?
While galantamine hydrobromide offers health benefits in people suffering from Alzheimer’s disease, there may be some unwanted galantamine side effects. There are galantamine side effects that may but not everyone may experience them.
The most common side effects that you may experience with use of galantamine are;
- nausea
- vomiting
- drowsiness
- diarrhea
- dizziness
- headache
- loss of appetite
- heartburn
- weight loss
- stomach pain
- insomnia
- runny nose
These symptoms are common when you start taking galantamine but are usually mild and may disappear with the continued use of the medicine. However, if they persist or become severe be sure to call your doctor for professional advice.
Serious side effects
Some people may experience serious side effects. These adverse effects are uncommon and you should call your doctor as soon as you notice them.
The serious side effects include:
- Severe allergic reaction such skin rash, itching and sometimes swelling of face, throat or tongue.
- symptoms of atrioventricular block including slow heart rate, tiredness, dizziness and fainting
- stomach ulcers and bleeding
- Vomits that is bloody or appear like coffee grounds
- Progression of lung problems in people with asthma or other lung diseases
- seizures
- trouble urinating
- severe stomach/abdominal pain
- blood in the urine
- burning sensation or pain during urination
some post marketing galantamine side-effects that have been reported include;
- seizures/ convulsions or fits
- hallucinations
- hypersensitivity,
- tinnitus (ringing in the ears)
- atrioventricular block or complete heart block
- hepatitis
- hypertension
- a raise in liver enzyme
- skin rash
- red or purple rash (erythema multiforme).
This is list many not contain all the galantamine side effects. It is therefore advisable to call your medical practitioner if you experience any unusual effects while taking this drug.
What kind of drugs interact with galantamine hydrobromide?
Drug interactions refers to the way some drugs influence others. These interactions affect the way some drugs work and may make the less effective or even accelerate the occurrence of side effects.
There are known galantamine hydrobromide interactions with other drugs. Your doctor may already be aware of some drug interactions. Your healthcare provider will be able to change some of your doses to minimize the chances of drug interactions or may as well change the medications completely. It may be beneficial for you to source medication and especially prescription from the same source such as pharmacy for proper combinations.
Also keep a list of medications you are taking and disclose this information to your health care provider before any prescription.
Some of the galantamine hydrobromide interactions are;
- Interactions with anti-depressants
These drugs are used to treat depression and may influence how galantamine works rendering it ineffective. These drugs include amitriptyline, desipramine, nortriptyline and doxepin.
- Interactions with drugs used to treat allergy
These allergy drugs may affect the way galantamine work.
These drugs include chlorpheniramine, hydroxyzine and diphenhydramine.
- Interaction with motion sickness medicines
These drugs influence the activity of galantamine hydrobromide.
These medicines include dimenhydrinate and meclizine.
- Alzheimer’s disease drugs
The drugs work similarly to galantamine hydrobromide. When these drugs are used together they may increase your risk of experiencing the possible side effects of galantamine. These medications include donepezil and rivastigmine.
However, some synergetic effects may be achieved with some combinations.
- Memantine
Galantamine and memantine are used to treat Alzheimer’s disease. While Galantamine is acetylcholinesterase inhibitor memantine is an NMDA receptor antagonist.
When you take galantamine and memantine together, you have better cognitive enhancement than when you use galantamine alone.
However, some earlier studies did not achieve significant improvement in cognitive function when galantamine and memantine were used together.
- Interactions with drugs for overactive bladder
These medications influence how galantamine works. If you used together you may not reap from galantamine. These drugs include darifenacin, tolterodine, oxybutynin and trospium.
- Stomach medications
These drugs include dicyclomine, loperamide and hyoscyamine. They may affect how galantamine works.
- Galantamine and autism drugs
When galantamine and autism drugs such as risperidone are used together. It has been reported to improve some of the symptoms of autism such as irritability, lethargy, and social withdrawal
Where can we get this product?
Galantamine hydrobromide can be sourced from your local pharmacist or from online stores. Customers of galantamine buy it from approved pharmacist who can prescribe the medication. If you consider galantamine buy it from reputable organizations and only use it as prescribed by your health care provider.
Conclusion
Galantamine is a good prescription drug for treating the symptoms of dementia associated with Alzheimer’s disease. It is however not a cure for the disease since it does not eliminate the underlying process of Alzheimer’s disease.
It should be used as a component in Alzheimer’s disease therapy along other strategies. It is an excellent supplement due to its dual mechanism of increasing acetylcholine in the brain. It offers additional benefits in neural protection by preventing oxidative stress.
References
- Wilcock GK. Lilienfeld S. Gaens E. Efficacy and safety of galantamine in patients with mild to moderate Alzheimer’s disease. 2000;321:1445-1449.
- Lilienfeld, S., & Parys, W. (2000). Galantamine: additional benefits to patients with Alzheimer’s disease. Dementia and geriatric cognitive disorders, 11 Suppl 1, 19–27. https://doi.org/10.1159/000051228.
- Tsvetkova, D., Obreshkova, D., Zheleva-Dimitrova, D., & Saso, L. (2013). Antioxidant activity of galantamine and some of its derivatives. Current medicinal chemistry, 20(36), 4595–4608. https://doi.org/10.2174/09298673113209990148.
- Loy, C., & Schneider, L. (2006). Galantamine for Alzheimer’s disease and mild cognitive impairment. The Cochrane database of systematic reviews, (1), CD001747. https://doi.org/10.1002/14651858.CD001747.pub3.