TACRINE

Brand & Generic Names

Cognex

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? No
• Drug class: Cholinesterase Inhibitor

Uses

Treatment for symptoms of mild to moderate Alzheimer's disease. May improve memory, reasoning and other cognitive functions slightly in some people.

Dosage & Usage Information

How to take:
Capsule--Swallow with liquid.

When to take:
At the same times each day. Take 1 hour before or 2 hours after eating. Follow doctor's instructions.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Slows breakdown of a brain chemical (acetycholine) that gradually disappears from the brains of people with Alzheimer's.

Time lapse before drug works:
May take several months before beneficial results are observed. Dosage is normally increased over a period of time to help prevent adverse reactions.

Don't take with:
Any other prescription or non-prescription drug without consulting your doctor.
See Interaction section and consult doctor.

Overdose

SYMPTOMS:
Severe nausea and vomiting, excessive saliva, sweating, blood pressure decrease, slow heartbeat, collapse, convulsions, muscle weakness (including respiratory muscles, which could lead to death).

WHAT TO DO:

• Dial 911 (emergency) or 0 (operator) for an ambulance or medical help. Then give first aid immediately.
• If patient is unconscious and not breathing, use cardiac massage and mouth-to-mouth breathing (CPR). Don't try to make patient vomit. If you can't get help quickly, take patient to nearest emergency facility.
• See EMERGENCY information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see previous section.

Common:

Nausea, vomiting, diarrhea, lack of coordination.

Infrequent:

Rash, indigestion, headache, muscle aches, loss of appetite, stomach pain, nervous- ness, chills, dizziness, dry or itching eyes, increased sweating, joint pain, runny nose, sore throat, swelling of feet or legs, insomnia, weight loss, unusual tiredness or weakness, flushing of face.

Rare:

Changes in liver function (yellow skin or eyes; black, very dark or light stool color); lack of coordination, convulsions.

Warnings & Precautions

Don't take if:
You are allergic to tacrine or acridine derivatives*.

Before you start, consult your doctor:

• If you have heart rhythm problems.
• If you have a history of ulcer disease or are at risk of developing ulcers.
• If you have a history of liver disease.
• If you have a history of asthma.
• If you have had previous treatment with tacrine that caused jaundice (yellow skin and eyes) or elevated bilirubin.

Over age 60:
No problems expected.

Pregnancy:
Unknown effect. Drug is usually not prescribed for women of childbearing age.

Breast-feeding:
Unknown effect. Not recommended for women of childbearing age.

Infants & children:
Not used in this age group.

Prolonged use:

• Drug may lose its effectiveness.
• Talk to your doctor about the need for followup medical examinations or laboratory studies to check blood chemistries and liver function.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take other medicines affecting alertness and reflexes such as anti- histamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:
Do not discontinue drug unless advised by doctor. Abrupt decreases in dosage may cause a cognitive decline.

Others:

• Advise any doctor or dentist whom you consult that you take this medicine.
• May affect the results in some medical tests.
• Do not increase dosage without doctor's approval.
• Treatment with tacrine may need to be discontinued or the dosage lowered if weekly blood tests indicate a sensitivity to the drug or liver toxicity develops.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
-------------------------	-----------------------
Anticholinergics*	Decreased anticholinergic effect.
Cimetidine	Increased tacrine effect.
Theophylline	Increased theophylline effect.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	None expected.
Beverages:	None expected.
Cocaine:	None expected.
Foods:	None expected.
Marijuana:	None expected.
Tobacco:	May decrease tacrine effect.