ALZIL M FORTE Tablet 10?s Allschoolabs -

Description

INTRODUCTION
ALZIL M FORTE is a combination of Donepezil and Memantine which belongs to the group of medicines called Acetylcholinesterase inhibitors and NMDA receptor antagonists respectively. It is used to treat moderate to severe dementia caused due to Alzheimer?s disease (Alzheimer?s type dementia) in patients previously treated with donepezil alone. Alzheimer?s type dementia is a type of brain disease where the dementia (disorder of thoughts, memory, and behaviour) happens due to degeneration of brain cells that carry memories.
Donepezil is an acetylcholinesterase inhibitor. It acts by restoring the levels of a brain chemical called acetylcholine that carries messages within the nerve cells. Memantine is a NMDA receptor antagonist. It acts by suppressing the overactivation of certain brain chemicals (glutamate) that damages the nerve cells. Together, they help in reducing the symptoms of Alzheimer?s type dementia.
Before taking ALZIL M FORTE inform your doctor if you have any liver, kidney, or heart problems. You must also inform your doctor if you have any stomach problems (ulcer or bleeding in the gut), breathing problems (asthma), bladder problems, epilepsy or are severely dehydrated due to excessive sweating, vomiting or diarrhea.
Consult your doctor before taking ALZIL M FORTE if you are pregnant or breastfeeding. ALZIL M FORTE may cause nausea and vomiting during the initial days of therapy. These side effects are unusually temporary and disappears as your body gets used to ALZIL M FORTE. However, consult your doctor if they worsen. Other most common side effects of taking ALZIL M FORTE are headache, dizziness, and loss of appetite.
USES OF ALZIL M FORTE

Treats moderate to severe Alzheimer?s type dementia

HOW ALZIL M FORTE WORKS
ALZIL M FORTE effectively controls the symptoms of dementia and Alzheimer?s disease by regulating the levels of certain chemical messengers (acetylcholine and glutamate) in the brain. Acetylcholine is a brain chemical which plays an important role in the functions of memory and cognition. Glutamate is another brain chemical that controls brain?s overall excitation. Overactivation of glutamate may cause damage to nerve cells. Alzheimer?s disease is usually characterized by decreased acetylcholine levels and increased glutamate levels in the brain.
ALZIL M FORTE contains two medicines, namely donepezil and memantine. Donepezil acts by restoring the levels of acetylcholine in the brain by blocking the actions of an enzyme called acetylcholinesterase which usually breaks down acetylcholine. Memantine acts by suppressing the overactivation of glutamate in the brain that causes nerve damage. Together, they restore the balance between chemical messengers in the brain, regulates proper transmission of nerve signals and reduces the symptoms of Alzheimer?s type dementia.
DIRECTIONS FOR USE
Take ALZIL M FORTE as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. ALZIL M FORTE can be taken with or without food. Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition.
SIDE EFFECTS OF ALZIL M FORTE

COMMON

Diarrhea

Bruising (bleeding under the skin)

Headache, dizziness

Nausea, vomiting

Loss of appetite

Increased weight

Loss of bladder control

Back pain

Drowsiness

RARE
Stop taking ALZIL M FORTE and consult your doctor immediately if you experience any of the following side effects:
Muscle problems

Fast or slow or irregular heartbeat

Difficulty in passing urine

Fits (seizures)

Worsening of lung problems in people with asthma or other lung disease

Stomach or intestinal bleeding (causing black/bloody stools, vomit that contains blood or looks like coffee grounds, stomach pain)

Mental or mood changes such as depression or aggression

Severe dizziness or fainting

Signs of allergic reaction (such as skin rash, itching or swelling of the face/tongue/throat, severe dizziness, trouble breathing)

HOW TO MANAGE SIDE EFFECTS
Nausea and Vomiting:
Take ALZIL M FORTE with or just after meals. Stick to simple meals. Avoid eating oil rich or spicy foods. Consult your doctor if your nausea worsens.
Diarrhea:
Hydrate yourself by drinking plenty of fluids, such as water or fruit juices. Consuming ORS can also be beneficial. Do not self-treat diarrhea on your own. Consult your doctor if your diarrhea becomes uncontrollable.
Headache:
Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.
Dizziness:
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.
WARNING & PRECAUTIONS

PREGNANCY
There is no proper information regarding the use of ALZIL M FORTE in pregnant women. Therefore, consult your doctor before taking ALZIL M FORTE if you are pregnant, think you may be pregnant or planning to have a baby.
BREASTFEEDING
There is no proper information regarding the use of ALZIL M FORTE in breastfeeding women. Therefore, consult your doctor before taking it.
DRIVING AND USING MACHINES
Do not drive or operate any heavy tools or machines if you experience dizziness or drowsiness after taking ALZIL M FORTE.
ALCOHOL
Avoid consumption of alcohol while taking ALZIL M FORTE.
KIDNEY
ALZIL M FORTE should be used with caution in patients with kidney diseases. Therefore, consult your doctor before taking it.
LIVER
ALZIL M FORTE should be used with caution in patients with liver diseases. Therefore, consult your doctor before taking it.
ALLERGY
Do not take ALZIL M FORTE if you are allergic to Donepezil or Memantine.
LUNGS
ALZIL M FORTE should be used with caution in patients with lung problems (such as asthma or chronic obstructive pulmonary disease). Therefore, consult your doctor before taking it.
HEART DISEASE
ALZIL M FORTE should be used with caution in patients with heart problems. Therefore, consult your doctor before taking it.
OTHERS
Before taking ALZIL M FORTE, inform your doctor if you:
Have epilepsy

Have stomach problems (such as ulcers or bleeding in the gut)

Have bladder problems or difficulty in urination due to enlarged prostate

Need to undergo any surgical, dental, or other medical procedures

Have severe urinary tract infections

Recently made any changes to your diet (such as changed from a high-protein diet to a vegetarian diet)

Have severe dizziness or fainting

Have low levels of potassium or magnesium in the blood

Are severely dehydrated (due to excessive sweating, diarrhoea, or vomiting)
Use in pediatrics:
There is no proper information regarding the use of ALZIL M FORTE in children and adolescents (aged below 18 years). Therefore, consult your doctor before taking it.
Use in geriatrics:
ALZIL M FORTE should be used with caution in elderly patients (aged 65 years and above). Therefore, consult your doctor before taking it. Proper dose adjustment and careful monitoring are required in such patients.
INTERACTIONS
A. Drug-Drug Interaction:
Before taking ALZIL M FORTE inform your doctor if you are taking any of the following:
Carbonic anhydrase inhibitors (used to reduce edema) such as acetazolamide, methazolamide

Sodium bicarbonate (used to treat metabolic acidosis)

Non-steroidal anti-inflammatory drugs (used for pain relief) Ex. aspirin, ibuprofen, naproxen

Diuretics or water pills (used to treat edema and hypertension) Ex. furosemide, chlorothiazide

Marijuana (a psychostimulant drug that causes addiction)

Anesthesia (used before surgeries to cause numbness) Ex. lignocaine, bupivacaine, isoflurane, sevoflurane
Overdosage:
If you or anyone else took ALZIL M FORTE excessively, contact your doctor immediately or go to a nearby hospital straight away. Symptoms of overdosage might include passing out or trouble breathing, severe nausea or vomiting, excessive sweating, very slow heartbeat, slow or shallow breathing, seizures, restlessness, hallucinations, and loss of consciousness.
SYNOPSIS

Drug :??
Donepezil, Memantine
Pharmacological Category :?? Acetylcholinesterase inhibitors, NMDA receptor antagonists

Therapeutic Indication :??
Alzheimer?s type dementia
Dosage Forms :?? Tablet

MORE INFORMATION

Keep ALZIL M FORTE out of reach of children

Store ALZIL M FORTE at room temperature

FAQs ABOUT ALZIL M FORTE
How and when should I take ALZIL M FORTE?
ALZIL M FORTE is taken preferably after meals either in the morning or at night before going to bed. However, your doctor will decide the time of administration and number of doses to be taken per day based on your age, body weight and disease condition. Swallow the medicine with a glass of water. Do not crush or chew the medicine.
What if I forget to take a dose of?ALZIL M FORTE?
If you forget to take a dose of ALZIL M FORTE, take it as soon as you remember. However, if it is time to take the next dose, skip the missed dose and take the next one at regular times. Do not take a double dose of ALZIL M FORTE to compensate a missed dose, as it could lead to toxicity.
What precautions do I need to follow while taking ALZIL M FORTE?
Before taking ALZIL M FORTE, inform your doctor if you have any liver, kidney, or heart problems. You must also inform your doctor if you have bleeding in the stomach, asthma, or fits. Consult your doctor before taking ALZIL M FORTE if you are pregnant or think you may be pregnant or breastfeeding.
Can the use of ALZIL M FORTE cause headache?
Yes. ALZIL M FORTE may cause headache in some individuals. This side effect is unusually temporary and disappears as your body gets used to ALZIL M FORTE. However, consult your doctor if they become uncontrollable to manage.
Can I stop taking ALZIL M FORTE once my symptoms subside?
Do not stop taking ALZIL M FORTE without consulting your doctor, as it may make your symptoms to reappear. If you feel that your symptoms subside after taking ALZIL M FORTE, consult your doctor for advice. Your doctor will access your health condition and gradually reduce the dose of ALZIL M FORTE before complete cessation.
?Can ALZIL M FORTE cause vomiting?
Yes. ALZIL M FORTE may cause vomiting in some individuals. This side effect is unusually temporary and disappears as your body gets used to ALZIL M FORTE. Meanwhile, get adequate rest. Drink plenty of fluids to keep yourself hydrated. Avoid eating oil rich spicy foods. Stick to simple meals. However, consult your doctor if they become uncontrollable to manage.
What does ALZIL M FORTE do?
ALZIL M FORTE effectively controls the symptoms of dementia and Alzheimer?s disease by regulating the levels of certain chemical messengers (acetylcholine and glutamate) in the brain. It restores the balance between chemical messengers in the brain, regulates proper transmission of nerve signals and reduces the symptoms of Alzheimer?s type dementia.
Is it safe to take?ALZIL M FORTE?
Yes. ALZIL M FORTE is generally safe when taken at the doses prescribed by the physician. However, it may cause few minor side effects like nausea, vomiting, diarrhea, weak muscle, headache, dizziness. These side effects are unusually temporary and disappears as your body gets used to ALZIL M FORTE. However, consult your doctor if they become uncontrollable to manage.
Does ALZIL M FORTE improve cognition?
Yes. ALZIL M FORTE improves cognition in people suffering from mental illness like dementia. It controls the symptoms of dementia by increasing the levels of a chemical messenger (acetylcholine) in the brain which plays an important role in the functions of memory and cognition. As a result, it improves memory and reduce the unpleasant symptoms of dementia.
Can I take paracetamol along with ALZIL M FORTE?
Avoid concomitant use of NSAIDS like paracetamol or ibuprofen while taking ALZIL M FORTE, because it may increase the risk of bleeding. Consult your doctor for an alternative pain relief medicine.
Can ALZIL M FORTE be used in elderly patients?
Yes. ALZIL M FORTE should be used with caution in elderly patients (aged 65 years and above). Therefore, consult your doctor before taking it. Proper dose adjustment and careful monitoring are required in such patients.
Can ALZIL M FORTE cause diarrhea?
Yes. ALZIL M FORTE may cause diarrhea in some individuals. If you experience diarrhea, hydrate yourself by drinking plenty of fluids, such as water or fruit juices. Consuming ORS can also be beneficial. Do not self-treat diarrhea on your own. Consult your doctor if your diarrhea becomes uncontrollable.
REFERENCES
1. KD. Tripathi. CNS Stimulants and Cognition Enhancers. Essentials of medical pharmacology. Seventh edition. 2013. Page ? 490.
2. Rob Jones 1, Bart Sheehan, Patrick Phillips, Ed Juszczak, Jessica Adams, Ashley Baldwin, Clive Ballard, Sube Banerjee, Bob Barber, Peter Bentham, Richard Brown, Alistair Burns, Tom Dening, David Findlay, Richard Gray, Mary Griffin, Clive Holmes, Alan Hughes, Robin Jacoby, Tony Johnson, Roy Jones, Martin Knapp, James Lindesay, Ian McKeith, Rupert McShane, Ajay Macharouthu, John O?Brien, Caroline Onions, Peter Passmore, James Raftery, Craig Ritchie, Rob Howard, DOMINO-AD team. DOMINO-AD protocol: donepezil and memantine in moderate to severe Alzheimer?s disease ? a multicentre RCT. NIH: National Library of Medicine, National center of biotechnology Information Pubmed.gov. July 2009. [Accessed on 30th Mar 2022]?https://pubmed.ncbi.nlm.nih.gov/19630974/
3. Amneal Pharmaceuticals. [Revised on Oct 2016] [Accessed on 30th Mar 2022]?https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2335950c-be3b-4248-ad04-e9763aee47d2
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