Galantamine

What galantamine is and how it works

Galantamine is a prescription medicine that increases the amount of acetylcholine (a brain chemical involved in memory and thinking) by blocking the enzyme that breaks it down, and by boosting nicotinic receptor activity. It is used to treat symptoms of mild to moderate, or moderately severe, Alzheimer's disease dementia. (1) (2)

Galantamine does not stop or reverse Alzheimer's disease, but it may help with memory, thinking, and daily function for some people for a period of time. It has genuine cardiac and skin-reaction risks that need to be discussed with a clinician before and during treatment, and dosing is started low and increased slowly to reduce side effects.

Mechanism of action: how galantamine works

Galantamine is a reversible, competitive inhibitor of acetylcholinesterase and also allosterically modulates nicotinic acetylcholine receptors, increasing central cholinergic transmission thought to be relevant to the cognitive symptoms of Alzheimer's disease. (1) (3) (4)

What galantamine is used for

Before taking galantamine

Do not take / not appropriate for

• Do not take galantamine if you have a known hypersensitivity to galantamine or any of the tablet/capsule/solution ingredients. (all countries) (1) (2)
• Do not take galantamine if you have severe liver impairment, or both significant kidney and liver problems together. (all countries) (2) (1)
• Do not take galantamine if your kidney function is very severely reduced (creatinine clearance below 9 mL/min). (all countries) (1) (2)

Tell your clinician about

• Any history of slow heart rate, heart block, unexplained fainting, or any heart rhythm problem, including a prolonged QT interval, or if you take other medicines that can affect heart rhythm.
• Any history of stomach ulcers, gastrointestinal bleeding, or if you take NSAID pain relievers regularly.
• Any history of asthma or severe COPD, seizures, or difficulty passing urine (possible bladder outflow obstruction).
• All other medicines you take, especially other cholinesterase inhibitors, medicines that affect heart rhythm, or muscle relaxants used during anaesthesia (such as succinylcholine).
• Whether you are pregnant, plan to become pregnant, or are breastfeeding.
• Any unexplained weight loss, as this needs to be monitored during treatment.

How to take galantamine

• There are two different dosing schedules depending on which formulation you have been prescribed -- always follow the instructions for your specific product.
• Immediate-release tablets or oral solution are taken twice daily, ideally with morning and evening meals, with adequate fluid intake.
• Extended/prolonged-release capsules are taken once daily in the morning, preferably with food, and swallowed whole (not chewed or crushed).
• Do not change your dose or stop taking galantamine without your clinician's guidance -- doses are increased slowly, over weeks, to reduce side effects.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

If you miss a dose, contact your prescriber or care team for guidance rather than doubling the next dose. If several days of doses are missed, do not simply resume at the previous dose without checking with your clinician, since restarting at too high a dose can increase side effects.

Overdose

Seek urgent medical attention if you think too much galantamine has been taken, or if you develop severe nausea/vomiting, a very slow heart rate, fainting, severe muscle weakness, seizures, or collapse -- overdose has been associated with dangerous heart rhythm changes (torsade de pointes). (3) (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Serious warnings

Interactions

• Other cholinesterase inhibitors, cholinergic agonists, and muscle relaxants used in anaesthesia (such as succinylcholine) may have synergistic (additive) effects with galantamine. (1) (4)
• Anticholinergic medicines may work less well when taken with galantamine. (1) (4)
• Strong CYP2D6 or CYP3A4 inhibitors (such as paroxetine or ketoconazole) can increase galantamine levels in the body (paroxetine has been shown to increase exposure by up to 40-48%); a dose reduction may be needed. (2) (4)
• Other medicines that slow the heart rate or affect the QT interval may increase the risk of cardiac side effects when combined with galantamine. (3) (2)

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Baseline heart rate/rhythm assessment, especially in patients with known cardiac conduction problems or unexplained syncope
• Baseline weight
• Review of other medicines for cholinergic, cardiac, or CYP2D6/3A4-interacting effects
• Liver and kidney function, to guide dosing

During treatment

• Ongoing monitoring for bradycardia, syncope, or other cardiac symptoms, especially during dose increases
• Body weight monitoring, given the association with clinically significant weight loss
• Prompt assessment of any new skin rash
• Assessment for signs of GI bleeding, especially in patients with ulcer history or concurrent NSAID use

Storage

Store at room temperature in the original packaging, protected from moisture, out of reach of children.

Frequently asked questions

References

1. GALANTAMINE tablets, for oral use -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information · United States · accessed 2026-07-31 · source 1
2. Galantamine 24 mg prolonged-release hard capsules -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- KRKA UK Ltd · United Kingdom · accessed 2026-07-31 · source 2
3. Galantamine -- CMDh scientific conclusions and grounds for variation to the terms of the marketing authorisation(s) (PSUSA/00001512/202003)European Medicines Agency (EMA) -- PRAC/CMDh scientific conclusions and grounds for variation · European Union · accessed 2026-07-31 · source 3
4. REMINYL ER (galantamine hydrobromide extended-release capsules) -- Product MonographHealth Canada product monograph, Janssen Inc. · Canada · accessed 2026-07-31 · source 4
5. REMINYL galantamine 8 mg (as hydrobromide) modified-release capsule blister pack -- ARTG entry 97883Therapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-31 · source 5
6. REMINYL Capsules -- New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-31 · source 6

Brand names by country

Single-ingredient galantamine names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries