Table 1Current drug treatments for Alzheimer's disease

AgentTacrine (Cognex)Donepezil (Aricept)Rivastigmine (Exelon)Galantamine (Razadyne Razadyne ER)Memantine (Namenda™)
Manufacturer/ DistributorWest-Ward
Horizon
Eisai
Pfizer
NovartisJanssen
Shire
Merz
Forest
Mechanism(s)AChEI, BuChEIAChEIAChEI, BuChEIAChEI, NRMNMDA antagonist
Dose Forms (mg)10, 20, 30, 405, 101.5, 3, 4.5, 64, 8, 12d
4mg/mld
8, 16, 24e
5, 10
Dose Frequency4x /day1x /day2x /day2x /dayd
1x /daye
2x /day
Serum T1/2 (hrs.)1.3 – 2702 – 8 a6 – 860 – 80
Dose Range40 – 160 mg/d5 – 10 mg/d3 – 12 mg/d8 – 24 mg/d5 – 20 mg/d
Target Dose80 – 160 mg/d5 – 10 mg/d6 – 12 mg/d16 – 24 mg/d10 – 20 mg/d
Dose Titration6 wks.4 – 6 wks.2 – 4 wks.4 wks.1 wk.
Metabolism bCYP1A2CYP2D6, 3A4Non-hepaticCYP2D6,3A4Non-hepatic
Protein-binding75%96%40%18–19%45%
Taken with food?YesNot necessaryYesYesNot necessary
Hepatotoxicity?Yes cNoNoNoNo

AChEI = Acetylcholinesterase inhibition

BuChEI = Butyrylcholinesterase inhibition

NRM = Nicotinicreceptor modulator

NMDA = N-methyl d-aspartate

a

Pseudo-irreversible binding; upper range reflects duration of esterase inhibition

b

Hepatic cytochrome p450 enzyme metabolism

c

Requires periodic monitoring of serum liver transaminases (AST, ALT)

d

Razadyne

e

Razadyne ER

From: Introduction

Cover of Drug Class Review: Alzheimer's Drugs
Drug Class Review: Alzheimer's Drugs: Final Report [Internet].
Hansen RA, Gartlehner G, Kaufer DJ, et al.
Portland (OR): Oregon Health & Science University; 2006 Jun.
Copyright © 2006, Oregon Health & Science University, Portland, Oregon.

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