Caution is recommended in patients with epilepsy, former history of convulsions or patients with predisposing factors for epilepsy.
Concomitant use of N-methyl-D-aspartate (NMDA)-antagonists such as Amantadine, Ketamine or Dextromethorphan should be avoided. These compounds act at the same receptor system as Memantine, and therefore adverse reactions (mainly central nervous system (CNS)-related) may be more frequent or more pronounced.
Some factors that may raise urine pH may necessitate careful monitoring of the patient. These factors include drastic changes in diet, e.g. from a carnivore to a vegetarian diet, or a massive ingestion of alkalizing gastric buffers. Also, urine pH may be elevated by states of renal tubulary acidosis (RTA) or severe infections of the urinary tract with Proteus bacteria.
This preparation contains Sodium metabisulfite that may cause serious allergic type reactions in certain susceptible patients. Do not use if known to be hypersensitive to bisulfites.
Effects on the ability to drive and use machines: Moderate to severe Alzheimer's disease usually causes impairment of driving performance and compromises the ability to use machinery. Furthermore, Memantine has minor to moderate influence on the ability to drive and use machines such that outpatients should be warned to take special care.