Market W Withdraw wal of Meemantinee (N Namendaa®) Tableets Effective A August 15, 20 014, Forest Laaboratories, Inc. will disconntinue the saales of meman ntine (Namen nda®) immediatte release (IR)) tablets. Mem mantine (Nam menda®) oral solution (OS)) and extendeed release (ER R) memantin ne capsules (N Namenda XR® ®) will continu ue to be avai lable. This is aa business deecision from FForest Labs to fo ocus on marke eting of their branded Nam menda XR® caapsules, not aa safety conceern. Patent exclusivityy for the mem mantine IR tab blets expires in April 2015 . All memantine products are indicated d for the treatm ment of mode erate to severre Alzheimer''s disease (AD D).1,2 During the transition p phase, meman ntine IR table ets will continnue to be avaiilable until cu urrent suppliees are orms are at so ome risk for sshortages as pprescribers an nd patients m may decide to o depleted. All dosage fo 3 switch or to simply discontinue the medication. For patien nts at end of llife and those e with advancced or end‐staage dementiaa, memantinee has little if aany therapeuttic benefit. Asssess patient’’s cognitive fu unction usingg the Function nal Assessmen nt and Staging Tool (FASTT) and the Paalliative Performance Scale e (PPS). Recom mmend disco ontinuing use of medications for demen ntia, includingg memantine e, for patientss meeting anyy or all of the following critteria: FA AST score wo orse than 7A (patient unable to commu nicate or makke needs kno own) Wish to reduce W e pill burden, due to dysph hagia or swal lowing difficu ulties Presence of bo othersome sid de effects (hyypotension, d izziness, head dache, anxietty, constipatio on, co ough, drowsin ness) Decline in funcction and cognition despite e ongoing usee of dementiaa medications If a patien nt is appropria ate to continu ue using mem mantine, theraapy must be sswitched to eeither meman ntine OS or mem mantine ER ca apsules.1,2 For conveersion to ER ca apsules (capsules may be o opened and ssprinkled on aapplesauce): Memantine 10 M 0mg IR tabletss BID convertts to memanttine ER 28mg capsules daily Memantine 5m M mg IR tablets BID converts to memantinne ER 14mg capsules daily For conveersion to oral ssolution: Memantine 10 M 0mg IR tabletss BID convertts to memanttine OS 10mg (5mL) BID Memantine 5m M mg IR tablets BID converts to memantinne OS 5mg (2.5mL) BID Fo or patients w with severe kid dney impairm ment (CrCl < 300mL/min) maax dose is 14m mg daily Fo or patients w with severe liver impairmen nt, use with c aution Average W Wholesale Prrice of Memantine Produccts as of July 228, 20142 Memantine oral solution n 10mg//5mL (pepperm mint flavor) Memantine immediate release tablets 5mg, 1 10mg tablets Memantine extended release capsules 7mg, 1 14mg, 21mg, 228mg capsules $20.15/day D) (5mL with BID $11.50/day (1 tab BID) $10.95/day (1 cap QDay) For patien nt‐specific qu uestions abou ut discontinuiing or converrting memanttine, please ccontact the HospiScrip pt clinical pharmacists forr assistance. References oratories, Inc. A Available at 1. Szzegedi A. Dear Healthcare Provider letter dated June 201 4. Forest Labo htttp://www.nam menda.com/Asssets/pdf/HCP% %20Letter_0611914%20.pdf. Accessed July 28, 2014. 2. Le exi‐Comp Onlin ne. Lexi‐Drugs Online. Hudson, Ohio: Lexi‐CComp, Inc.; Julyy 28, 2014. 3. American Societty of Health‐Syystem Pharmaccists (ASHP). D rug shortages:: Current shorttages. hp.org/menu/D DrugShortages//CurrentShort ages. Accessed d July 28, 2014 4. htttp://www.ash © 2014, HospiScript H Servvices [email protected] w www.hospiscrippt.com tel: 800-227-08488 fax: 800-6166-2479
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