Namzaric (donepezil and memantine), also known as MDX-8704, ADS-8704, and Arimenda, is an approved therapy for moderate to severe Alzheimer’s disease. Allergan markets the treatment in the U.S. and Adamas markets it elsewhere.

Namzaric offers temporary relief from the symptoms of Alzheimer’s disease. It does not prevent or slow the underlying cause of the disease, nerve cell death.

How Namzaric works

Alzheimer’s disease is a progressive neurodegenerative disorder. Its hallmark is nerve cell death in the brain that diminishes memory and a person’s ability to think.

Namzaric is a combination of two Alzheimer’s therapies, donepezil (marketed by Allergan under the brand name Aricept) and memantine (marketed by Eisai and Pfizer as Namenda).

Donepezil offers a temporary reprieve from Alzheimer’s symptoms by improving the communication between nerve cells in the brain that are still healthy.

It inhibits acetylcholinesterase, an enzyme that breaks down the neurotransmitter acetylcholine. A neurotransmitter is a chemical that the brain uses to pass signals between nerve cells.

In Alzheimer’s, reduced acetylcholine signaling in the brain is thought to be one of the causes of reduced memory and judgment. By blocking acetylcholinesterase, donepezil increases acetylcholine levels, improving communication between brain cells.

Memantine regulates the neurotransmitter glutamate, which damaged nerve cells produce in abnormally high amounts. When glutamate binds to receptors found on the surface of nerve cells, the interaction allows a tightly controlled amount of calcium to enter the cells. This process is essential for cell signaling involved in memory and learning.

Excessive glutamate binding leads to too much calcium entering nerve cells, disrupting the signaling process and causing damage and cell death. Memantine can prevent excess glutamate from accessing the receptors, reducing the amount of calcium entering cells and potentially reducing nerve cell damage.

Namzaric in clinical trials

The U.S. Food and Drug Administration (FDA) approved Namzaric as a treatment for moderate to severe Alzheimer’s disease in December 2014. Initially, the agency authorized it for patients who were taking both donepezil and memantine, but in July 2016 it expanded the authorization to patients taking donepezil only.

The approval was based on the results of a randomized, double-blind, placebo-controlled clinical trial in 677 Alzheimer’s disease patients. The trial assessed the safety and effectiveness of a combination of donepezil and memantine, compared with donepezil or an equivalent acetylcholinesterase inhibitor, and a placebo.

Patients taking the combo significantly improved their cognition and function, compared with those taking a placebo, after 24 weeks. The metrics that researchers used to measure improvement were changes in patients’ scores on tests known as the severe impairment battery and the clinician’s interview-based impression of change plus caregiver input.

Other information

Namzaric is taken by mouth once a day either as a capsule or sprinkled on food. It is available in two doses — one twice as large as the other.

The most common side effects associated with Namzaric are nausea, vomiting, diarrhea, loss of appetite, headache, dizziness, and bruising.

 

Last updated: July 23, 2019

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