Galantamine, galanthamine hydrobromide, Galanthus nivalis, G. woronowii Galanthamine is an alkaloid and a selective, long-acting acetylcholinesterase inhibitor derived from the plant Galanthus nivalis or G. woronowii. It antagonizes the muscle relaxation caused by nondepolarizing, curare-like muscle relaxants.
Galanthamine may also modulate nicotinic cholinergic receptors and help improve daily functioning in patients with Alzheimer’s disease. It’s available in oral and LV. solutions and tablets, in products such as Jilkon, Lycoremin, and Nivalin.
Reported uses
Galanthamine is used to treat symptoms of Alzheimer’s disease, neuromuscular disorders, and mania. It’s also used postoperatively to reverse the effects of neuromuscular blockers.
Administration
- Alzheimer’s disease: Dosage is 20 to 50 mg by mouth every day, administered in 2 to 3 divided doses; the lowest possible dose should be used.
- Reversal of neuromuscular blockers: Dosage is 0.3 mg/kg LV.
Hazards
Galanthamine may cause agitation, sleep disturbances, insomnia, light headedness, bradycardia, nausea, vomiting, diarrhea, and anorexia. When used with other cholinergics (parasympathomimetics), there is the potential to increase adverse effects including bradycardia, hypotension, and respiratory distress.
Those with a known allergy or hypersensitivity to galanthamine should avoid use. Pregnant and breast-feeding patients, and those with gastrointestinal ulcer, Parkinson’s disease, severe heart disease, bradycardia, bronchial asthma, epilepsy, hyperkinesia, ileus, or ureter occlusion should also avoid use.
Clinical considerations
- Galanthamine is considered an investigational drug in the treatment of Alzheimer’s disease. More studies are being conducted to assess its efficacy. It may not be available for public use.
- Response to drug for Alzheimer’s disease and mania may take 6 to 8 weeks.
- If patient is also taking an anti parkinsonian, monitor closely for symptom improvement or progression and adverse effects.
- Monitor patient for agitation, weight loss, and bradycardia.
- If patient is pregnant or breastfeeding, advise her not to use galanthamine. . Tell patient to take with meals, if possible.
- Tell patient to remind pharmacist of any herbal or dietary supplement that he’s taking when obtaining a new prescription.
- Advise patient to consult his health care provider before using an herbal preparation because a conventional treatment with proven efficacy may be available.
Research summary
The concepts behind the use of galanthamine and the claims made regarding its effects haven’t yet been validated scientifically.