<p>The recommended maintenance dose of Memantine&nbsp;for adults and older patients is 20 mg every day. In order to lower the risk of side effects, the dose should be achieved by upward titration with 5 mg per week over 3 weeks, achieving the maintenance dose of 20 mg/day from the start of week 4 according to the following dosage guideline:<br />
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<strong>Week 1 (Everyday)</strong>:&nbsp;Morning- 5 mg (1 tablet),&nbsp;Night- No dose<br />
<strong>Week 2 (Everyday)</strong>:&nbsp;Morning- 5 mg (1 tablet),&nbsp;Night- 5 mg (1 tablet)<br />
<strong>Week 3 (Everyday)</strong>:&nbsp;Morning- 10 mg (2 tablets),&nbsp;Night- 5 mg (1 tablet)<br />
<strong>Week 4 and onwards (Everyday)</strong>:&nbsp;Morning- 10 mg (2 tablets),&nbsp;Night- 10 mg (2 tablets)<br />
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<strong>Missed Dose</strong>: If any dose is missed, just wait and take the next dose at the usual time. Do not double the dose to compensate for the missed dose.<br />
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<strong>In case renal impairment</strong>: In patients with moderate renal impairment (creatinine clearance 30-49 ml/min) daily dose should be 10 mg (1 ml solution, equivalent to two downward strokes). If tolerated well after at least 7 days of treatment, the dose could be increased up to 20 mg/day according to standard titration scheme. In patients with severe renal impairment (creatinine clearance 5-29 ml/min) daily dose should be 10 mg (1 ml solution, equivalent to two downward strokes) per day.<br />
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<strong>In case of hepatic impairment</strong>: In patients with mild or moderate hepatic impaired function, no dosage adjustment is needed. Administration of memantine is not recommended in patients with severe hepatic impairment.<br />
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<strong>Children under 18 years</strong>: Memantine is not recommended for use in children below 18 years due to lack of data on safety and efficacy.</p>