Memry Dosage/Direction for Use

Tablet: Memantine hydrochloride can be taken with or without food.
Recommended Starting Dose: 5 mg once a day.
Recommended Maximum Dose: 20 mg per day.
The dose should be increased in 5 mg increments over the first four weeks of treatment reaching the recommended maintenance dose as follows: See Table 1.

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The minimum recommended interval between dose increase is one week.
Recommended Maintenance Dose: 20 mg per day.
Hepatic Impairment: In patients with mild or moderate hepatic impairment (Child-Pugh A and Child-Pugh B), no dosage adjustment is required. No data is available for patients with severe hepatic impairment. Administration of memantine is not recommended in patients with severe hepatic impairment.
Renal Impairment: Patients with mild renal impairment (CL_cr: 50 to 80 mL/min): No dosage adjustment is required in patients with mild renal impairment.
Patients with moderate renal impairment (CL_cr: 30 to 49 mL/min): 10 mg per day.
If well-tolerated after at least seven days of treatment, the dose can be increased up to 20 mg per day according to the standard titration scheme.
Patients with severe renal impairment (CL_cr: 5 to 29 mL/min): 10 mg per day.
Elderly (over 65 years old): 20 mg per day.
Or, as prescribed by a physician.
Oral soln: Treatment should be initiated and supervised by a physician experienced in the diagnosis and treatment of Alzheimer's dementia. Diagnosis should be made according to current guidelines. It is recommended that treatment with memantine be initiated when a caregiver is available to regularly monitor patient's intake. The clinical benefit and the patient's tolerance should be reassessed, preferably within 3 months after start of treatment, and on a regular basis thereafter.
Treatment with memantine should be continued if favorable therapeutic benefit and tolerability are observed. Discontinuation of memantine should be considered when evidence of a therapeutic effect is no longer present or if the patient does not tolerate treatment.
Memantine should be administered once per day and should be taken at the same time every day. If a dose is missed, the caregiver should be instructed to give the next dose to the patient as scheduled. There is no need to take the missed dose.
Memantine can be taken with or without food.
Recommended Oral Memantine Dose: Oral Solution: The maximum daily dose for adults is 20 mg daily. In order to reduce the risk of undesirable effects, the maintenance dose is achieved by upward titration of 5 mg per week over the first 3 weeks as follows: See Table 2.

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Maintenance Dose: The recommended maintenance dose is 20 mg per day.
Special Populations: Renal Impairment: In patients with mildly impaired renal function (CrCl 50 to 80 mL/min), no dose adjustment is required. In patients with moderate renal impairment (CrCl 30 to 49 mL/min), daily dose should be 10 mg per day. If tolerated well after at least 7 days of treatment, the dose could be increased up to 20 mg per day according to standard titration scheme.
In patients with severe renal impairment (CrCl of 5 to 29 mL/min), the maximum daily dose is 10 mg.
Hepatic Impairment: In patients with mild or moderate hepatic impaired function (Child-Pugh A and Child-to standard titration scheme adjustment is required. In patients with moderate renal impairment (CrCl 30 to 49 mL/min), daily dose should be 10 mg per day. If tolerated well after at least 7 days of treatment, the dose could be increased up to 20 mg per day according impairment.
Children: The use of memantine in patients below 18 years old is not recommended.
Elderly (65 years and older): The recommended dose of memantine in elderly patients is 20 mg per day.