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Patients at increased risk of developing peptic ulcerse.gthose with a history of ulcer disease or those predisposed to these conditionsincluding those receiving concurrent non-steroidal anti-inflammatory drugsNSAIDSshould be monitored for symptomsThe use of galantamine is not recommended in patients with gastro-intestinal obstruction or recovering from gastro-intestinal surgery.

A diagnosis of Alzheimer’s dementia should be made according to current guidelines by an experienced physicianTherapy with galantamine should occur under the supervision of a physician and should only be initiated if a caregiver is available who will regularly monitor medicinal product intake by the patient.

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.

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