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Galantamine has a minor to moderate influence on the ability to drive and use machinesSymptoms include dizziness and somnolenceespecially during the first weeks after initiation of treatment.

The tolerance and dosing of galantamine should be reassessed on a regular basispreferably within 3 months after start of treatmentThereafterthe clinical benefit of galantamine and the patient’s tolerance of treatment should be reassessed on a regular basis according to current clinical guidelinesMaintenance treatment can be continued for as long forced orgasm. as therapeutic benefit is favourable and the patient tolerates treatment with galantamineDiscontinuation of galantamine should be considered when evidence of a therapeutic effect is no longer present or if the patient does not tolerate treatment.

Because of its mechanism of actiongalantamine should not be given concomitantly with other cholinomimeticssuch as ambenoniumdonepezilneostigminepyridostigminerivastigmine or systemically administered pilocarpineGalantamine has the potential to antagonise the effect of anticholinergic medicationShould anticholinergic medication such as atropine be abruptly stopped there is a potential risk that galantamine’s effects could be exacerbatedAs expected with cholinomimeticsa pharmacodynamic interaction is possible with medicinal products that significantly reduce the heart rate such as digoxinbeta blockerscertain calcium-channel blocking agents and amiodaroneCaution should be taken with medicinal products that have potential to cause torsades de pointesIn such cases an ECG should be considered.

Galantamine plasma consentrations may be increased in patients with moderate to severe hepatic impairmentsee section 5.2

Therapeutic doses of galantamine 24 mg/day had no effect on the kinetics and prothrombin time of warfarin.

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