Dementia

Prescribing of anti-dementia drugs in primary care

AChE inhibitors are Amber-G on the Doncaster traffic light system Memantine is Green-G on the Doncaster traffic light system Where a patient has a diagnosis of dementia • RDaSH services will initiate AChE inhibitors and will be actively involved in patient care while establishing an appropriate management plan. Prescribing may be passed to primary care during this period when a medication has been determined to be effective and stable. • Memantine initiation may occur in primary care • by suitably experienced GPs or • following discussion with RDaSH OPMH specialist or commissioned dementia expert (eg Admiralty Nursing)

See RDaSH Formulary Guidance in section 4

For cost-effective prescribing it is recommended that oral solution is prescribed where clinically appropriate - Memantine orodispersible tablets are Grey listed

NICE NG97 Dementia: assessment, management and support for people living with dementia and their carers 

NICE TA217 Memantine for the treatment of Alzheimer's disease 

Advice for healthcare professionals:

* There are differences in dose delivery between the pump device and dropper device for memantine

* Please be vigilant regarding dose delivery for memantine products, particularly during the transition period from the dropper device to the new pump device. We request that you also advise patients and their caregivers:
- how to use the new pump device to deliver the prescribed dose
- to carefully read the Patient Information Leaflet for memantine oral solution
delivered by a pump device

Dementia

Rationale: 1,5,6

Prescribing restricted to Specialist Clinics only

Orodispersible tablets available for patients with swallowing difficulty

NICE NG97 Dementia: assessment, management and support for people living with dementia and their carers

NICE TA217 Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease