Metformin Memantine

SLC22A1 OCTl Organic cations (e.g., TEA, Amantadine, memantine, metformin, acyclovir. Liver Dresser et al., 2001 ... 

Memantine is not a major substrate for hepatic cytochrome P450 isoenzymes and has not been shown to significantly inhibit or induce these enzymes. However, memantine is partially excreted by renal tubular secretion. Thus, concomitant use of other medications that use the same renal system (i.e., triampterene, hydrochlorothiazide, digoxin, cimetidine, ranitidine, metformin, and quinidine) may affect plasma levels of both drugs (Namenda 2005). Memantine should not be used in combination with other NMDA receptor antagonists, such as amantadine or dextromethorphan, because these combinations have not been formally studied. The clearance of memantine can be reduced when the urine is alkalinized, such as with the concomitant use of sodium bicarbonate or carbonic anhy-... 

Drugs that make the urine alkaline (e.g. sodium bicarbonate, carbonic anhydrase inhibitors) will reduce the elimination of memantine. Memantine should be used with caution with other NMDA antagonists, such as amantadine, ketamine and dextromethorphan, or concurrent use should be avoided, because of the theoretical increased risk of adverse effects. Memantine is predicted to interact with other drugs eliminated by the same renal secretion mechanism, but no important interaction was seen with glibenclamide, hydrochlorothiazide, metformin or triamterene. 

The use of memantine with a combined product containing glibenclamide and metformin did not result in any changes in the pharmacokinetics of either of the three drugs. Memantine did not reduce the glucose-lowering effects of either drug. ... 

Memantine is predicted to interact with other drugs that use the same renal cationic transport system leading to increased levels of memantine and/or the other drug. The manufacturer lists cimetidine, ranitidine, hydrochlorothiazide, metformin, procainamide, qninidine, qninine and triamterene as possible examples. However, in an interaction study, the concurrent use of memantine and hydrochlorothiazide/triamterene did not result in any change in the steady-state AUC of memantine or triamterene, and the AUC of hydrochlorothiazide showed a modest reduction of about 20%. This degree of change is unlikely to be clinically relevant. Therefore, whether any clinically important interactions occur via this mechanism remains to be established. 

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See also in sourсe #XX -- [ ]

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