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Use of the other N-methyl-D-aspartate antagonist such as amantadine, ketamine or dextromethorphan with memantine may increase both the incidence and severity of adverse effects and should be avoided. The effects of dopaminergics and antimuscarinics may also be enhanced whereas memantine may reduce the actions of barbiturates and antipsychotics.
Memantine may alter the effects of antispasmodics baclofen and dantrolene. The clearance of memantine is reduced under alkaline urine conditions and drugs such as carbonic anhydrase inhibitors and sodium bicarbonate should be used with caution.
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