Galantamine (Reminyl) prolonged-release capsules for dementia in Alzheimer's disease Galantamine (Reminyl) prolonged-release capsules for dementia in Alzheimer's disease December 2004 Galantamine (Reminyl) 7 Galantamine (Reminyl) prolonged-release capsules for dementia in Alzheimer’s disease Summary Prolonged-release galantamine has been PBS listed as an authority item for initial and continuing treatment of mild to moderate Alzheimer’s disease. The listing was based on equivalence of the new formulation with the immediate-release formulation already listed on the PBS. There are no clinically relevant differences between prolonged-release and immediate-release galantamine. There is no reliable evidence of galantamine’s long-term effectiveness. Short-term trials have found only modest improvements in scores on rating scales of cognitive, psychological and behavioural functioning. Galantamine has similar efficacy to other cholinesterase inhibitors. Increasing the dose of galantamine above 16 mg/day is not associated with greater benefit, and is likely to increase adverse effects. There is doubt about the place in therapy of cholinesterase inhibitors. Recent evidence with donepezil (Aricept) found no effect on long-term outcomes relevant to patients and carers such as delay in progression of disability or institutionalisation, behavioural and psychological symptoms and active carer time. PBS Listing The new PBS listing is for prolonged-release, once-daily formulations of galantamine (8 mg, 16 mg, 24 mg) for initial and continuing treatment of mild to moderately severe Alzheimer’s disease. There is no change to the authority listing—see the Schedule of Pharmaceutical Benefits for the full authority requirements. Reason for PBS listing The PBAC considered the new once-daily capsules to be equivalent to the twice-daily tablets already listed on the PBS.
