Drug interactions
Memantine-donepezil + Physostigmine
Severity: Moderate
Memantine-donepezil and Physostigmine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Physostigmine and donepezil are both cholinesterase inhibitors, so using them together adds to cholinergic stimulation. This can cause bradycardia, nausea, vomiting, salivation, bronchospasm, and in extreme cases seizures or cholinergic crisis.
What this interaction means in plain words
Memantine-donepezil and Physostigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive acetylcholinesterase inhibition produces excess cholinergic stimulation.
What to do
Avoid routine concurrent use; if physostigmine is needed, monitor heart rate, respiratory status and cholinergic symptoms closely and have atropine available.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Memantine-donepezil
- Dronedarone + Memantine-donepezil Contraindicated
- Memantine-donepezil + Thioridazine Contraindicated
- Amantadine + Memantine-donepezil Major
- Amiodarone + Memantine-donepezil Major
- Amisulpride + Memantine-donepezil Major
- Amitriptyline + Memantine-donepezil Major
Frequently asked questions
Can I take Memantine-donepezil with Physostigmine?
MediHelp rates the interaction as moderate. Memantine-donepezil and Physostigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Physostigmine and donepezil are both cholinesterase inhibitors, so using them together adds to cholinergic stimulation. This can cause bradycardia, nausea, vomiting, salivation, bronchospasm, and in extreme cases seizures or cholinergic crisis.
How serious is the interaction between Memantine-donepezil and Physostigmine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid routine concurrent use; if physostigmine is needed, monitor heart rate, respiratory status and cholinergic symptoms closely and have atropine available.
What other medicines interact with Memantine-donepezil?
MediHelp also lists interactions of Memantine-donepezil with, for example, Dronedarone, Thioridazine, Amantadine. The full list is on the Memantine-donepezil page.
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