Namzaric 7mg-10mg Capsules

Namzaric combines two active ingredients: Memantine and Donepezil. Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist. It blocks the effects of abnormally high levels of glutamate, which is thought to contribute to neuronal dysfunction in Alzheimer's disease. Donepezil is a reversible inhibitor of acetylcholinesterase, the enzyme responsible for the hydrolysis of acetylcholine. By inhibiting acetylcholinesterase, donepezil increases the concentration of acetylcholine in the synaptic cleft, thereby enhancing cholinergic neurotransmission in the central nervous system.

Serious Side Effects: Seek Medical Help Immediately

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention right away:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Urination problems
Severe dizziness or fainting
Fever, chills, or sore throat
New or worsening breathing difficulties
Seizures
Stomach pain or heartburn
Black, tarry, or bloody stools
Vomiting blood or coffee ground-like material
Slow heartbeat
Abnormal heartbeat
Bruising

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor:

Diarrhea
Upset stomach or vomiting
Decreased appetite
Dizziness or headache
Muscle cramps
Fatigue or weakness
* Sleep disturbances

This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions.

To ensure your safety, it is crucial to verify that it is safe to take this medication with all your other medications and health conditions. Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor.

It is essential to inform all of your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. While this drug can help manage symptoms, it is not a cure for Alzheimer's disease, and you should continue to receive regular care from your doctor. If you are pregnant, planning to become pregnant, or are breast-feeding, be sure to discuss this with your doctor, as you will need to carefully weigh the potential benefits and risks of this medication to both you and your baby.

• Anticholinergics (e.g., atropine, scopolamine): Donepezil may antagonize their effects.
• Succinylcholine, other neuromuscular blocking agents: Donepezil may exaggerate neuromuscular blockade.
• Other acetylcholinesterase inhibitors (e.g., rivastigmine, galantamine): Increased risk of cholinergic side effects.

• Drugs that increase gastric pH (e.g., antacids, H2 blockers, proton pump inhibitors): May decrease donepezil absorption (though not clinically significant for most patients).
• Drugs eliminated by renal tubular secretion (e.g., hydrochlorothiazide, triamterene, cimetidine, ranitidine, quinidine, nicotine): Memantine is partially eliminated by tubular secretion; co-administration may alter memantine levels.
• Carbonic anhydrase inhibitors (e.g., acetazolamide), sodium bicarbonate: May decrease memantine excretion by alkalinizing urine, leading to increased memantine levels.
• CYP2D6 and CYP3A4 inhibitors (e.g., quinidine, fluoxetine, ketoconazole, erythromycin): May increase donepezil exposure.
• CYP2D6 and CYP3A4 inducers (e.g., rifampin, phenytoin, carbamazepine, phenobarbital): May decrease donepezil exposure.

• NSAIDs: Increased risk of GI bleeding with cholinesterase inhibitors, though not specifically for donepezil.

• Nausea
• Vomiting
• Diarrhea
• Dizziness
• Headache
• Confusion
• Agitation
• Insomnia
• Fatigue
• Muscle cramps
• Bradycardia (slow heart rate)
• Syncope (fainting)
• Seizures
• Urinary incontinence
• GI bleeding (black or tarry stools, coffee-ground vomit)

Category C. There are no adequate and well-controlled studies of Namzaric in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus.

L3 (Moderately safe). It is not known if memantine or donepezil are excreted in human milk. Donepezil is excreted in animal milk. The decision to discontinue nursing or discontinue the drug should consider the importance of the drug to the mother.

Safety and effectiveness in pediatric patients have not been established. Not indicated for use in children.

Alzheimer's disease primarily affects the elderly. Dosage adjustments are typically based on renal function, not age alone. Elderly patients may be more susceptible to cholinergic side effects (e.g., bradycardia, syncope) and should be monitored closely.

• Namzaric is a fixed-dose combination, simplifying dosing for patients already on stable doses of both memantine and donepezil, or for new patients starting combination therapy.
• Always take Namzaric in the evening, as donepezil is typically dosed once daily in the evening to minimize sleep disturbances.
• Titrate the dose slowly (weekly increments) to minimize gastrointestinal and CNS side effects.
• If a dose is missed, skip it and take the next dose at the regularly scheduled time. Do not double the dose.
• Patients should be monitored for signs of bradycardia, syncope, and GI bleeding, especially those with pre-existing cardiac conditions or a history of ulcers/NSAID use.
• Renal impairment requires dose adjustment for the memantine component.
• This medication treats symptoms but does not cure Alzheimer's disease.

• Donepezil (Aricept)
• Memantine (Namenda)
• Rivastigmine (Exelon, Exelon Patch)
• Galantamine (Razadyne)
• Aducanumab (Aduhelm) - for early AD, different mechanism
• Lecanemab (Leqembi) - for early AD, different mechanism

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed to do so by a healthcare professional, do not flush medications down the toilet or pour them down the drain. If you are unsure about the correct disposal method, consult your pharmacist for guidance. Many communities have drug take-back programs, which your pharmacist can help you locate. Some medications may come with an additional patient information leaflet; check with your pharmacist to see if this applies to your prescription. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it was taken, as this will aid in providing appropriate care.