Tacrine (Cognex)
Mechanism of Action: Presumably acts by elevating acetylcholine concentrations in the cerebral cortex by slowing the degradation of acetylcholine.
Therapeutic Use: Treatment of mild to moderate Alzheimer dementia (impaired intellectual functioning).
Absorption: Rapidly absorbed after oral administration. Maximal plasma concentration is reached in 1-2 hours.
Metabolism: Extensively metabolized by the cytochrome P-450 system to multiple metabolites, not all of which have been identified.
Half-life: 2-4 hours.
Average Daily Dose (adult): Initial dose is 40 mg/day (10 mg QID).
Adverse Effects: Abdominal cramps, nausea, vomiting and diarrhea. Elevation of liver enzymes. Bradycardia, dizziness, confusion, ataxia and insomnia.
Drug Interaction: Theophylline, Cimetidine, Anticholinergics, Cholinomimetics and Cholinesterase inhibitors.
Contraindication: Patients with known sensitivity to tacrine and patients with liver disease.
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