Table 1.
Pharmacologic Properties of Widely Approved Alzheimer’s Disease Treatments
| Name | Mechanism of Action | Elimination Half-life | Protein Binding | Metabolism | Starting Dose | Effective Dose | Maximal Dose |
|---|---|---|---|---|---|---|---|
| Donepezil | .Acetylcholinesterase inhibitor .Piperidine derivative |
70 hours | 96% | .Hepatic .Cytochrome P450 – 2D6 and 3A4 |
5mg once daily | 5mg once daily | 10 mg once daily |
| Rivastigmine (Oral) | .Acetylcholinesterase inhibitor .Butyrylcholinesterase inhibitor .Carbamate derivative |
1-2 hours | 40% | Urinary | 1.5 mg twice daily | 3.0 mg twice daily | 6 mg twice daily |
| Rivastigmine (Transdermal) | .Acetylcholinesterase inhibitor .Butyrylcholinesterase inhibitor .Carbamate derivative |
1-2 hours | 40% | Urinary | 5 cm2 | 10 cm2 | 10 cm2 |
| Galantamine ER | .Acetylcholinesterase inhibitor .Nicotinic allosteric agonist .Tertiary alkaloid |
7-8 hours | 18% | .Hepatic .Cytochrome P450 – 2D6 and 3A4 |
8 mg once daily | 16 mg once daily | 24 mg once daily |
| Memantine | .N-Methyl-D-Aspartate (NMDA) non-competitive receptor antagonist | 60-80 hours | 45% | Urinary | 5 mg daily (in 1 or 2 doses) | 10 mg daily (in 1 or 2 doses) | 20 mg daily (in 1 or 2 doses) |