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Treatment area: Dementia

Treating Alzheimer's dementia with medical supervision

Antidementia drugs are prescription medications that treat the symptoms of a medically diagnosed Alzheimer's dementia, but they do not cure the disease. Our doctors use a questionnaire, which patients ideally complete together with a caregiver, to determine whether treatment is appropriate.

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Ratgeber lesenRead the guideLire le guideGids lezen
  • online questionnaire
  • Medical examination
  • Discreet Shipping
  • Money back if not suitable

BehandlungsoptionenTreatment optionsOptions de traitementBehandelopties

Antidementia drugs for Alzheimer's dementia

All medications require a prescription and a personal diagnosis. After selection, a medical questionnaire is completed, and a doctor decides whether treatment is appropriate.

Selbst einschätzenAssess it yourselfFaire le point vous-mêmeZelf inschatten

Which treatment might be suitable?

  1. 1 In cases of mild to moderate Alzheimer's dementia Cholinesterase inhibitors are prescribed for this stage: donepezil as a tablet in the evening or galantamine as a sustained-release capsule in the morning. The doctor will decide which active ingredient is suitable.
  2. 2 In cases of moderate to severe Alzheimer's disease Memantine (Ebixa) is indicated for this stage and is taken once daily. Online treatment focuses on continuing a treatment already initiated by a specialist. The doctor decides.
  3. 3 If no diagnosis has yet been made or treatment has not yet started Diagnosis and initiation of treatment should be carried out by a physician experienced in dementia, for example, in a neurology practice or memory clinic. If a specialist recommendation is available, the physician decides whether a prescription is possible.
  4. 4 In cases of slow pulse, heart rhythm disorders, kidney disease, or many other medications Cholinesterase inhibitors can slow the heart rate, and with memantine, kidney function is important for determining the dosage. List all medical conditions and medications on the questionnaire. The doctor will decide.

Diese Hinweise helfen bei der Orientierung und ersetzen keine ärztliche Beratung. Ob und welche Behandlung für Sie geeignet ist, entscheidet der Arzt anhand Ihres Fragebogens.This guidance helps you get your bearings and does not replace medical advice. Whether a treatment is suitable for you, and which one, is decided by the doctor on the basis of your questionnaire.Ces indications vous aident à vous orienter et ne remplacent pas un avis médical. C’est le médecin qui décide, sur la base de votre questionnaire, si un traitement vous convient et lequel.Deze aanwijzingen helpen u op weg en vervangen geen medisch advies. Of en welke behandeling voor u geschikt is, bepaalt de arts aan de hand van uw vragenlijst.

Cholinesterase inhibitors

They slow down the breakdown of the neurotransmitter acetylcholine in the brain and are intended for mild to moderate Alzheimer's dementia.

Donepezil RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Donepezil

A tablet from the group of cholinesterase inhibitors for the treatment of mild to moderate Alzheimer's dementia.

WirkeintrittOnsetDélai d’actionWerkingsaanvang
Gradual assessment, evaluation no earlier than 1 month later.
WirkdauerDurationDurée d’actionWerkingsduur
once daily, half-life approximately 70 hours
FormFormFormeVorm
Tablets

So wirkt es:How it works:Mode d’action :Zo werkt het: Donepezil inhibits the enzyme acetylcholinesterase in the brain, which breaks down the neurotransmitter acetylcholine. This makes more acetylcholine available for signal transmission between nerve cells, which is reduced in Alzheimer's disease. However, it does not cure the disease itself.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • If Alzheimer's dementia has been medically diagnosed
  • If the dementia is classified as mild to moderate
  • If a caregiver accompanies the daily intake
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: One tablet once daily in the evening before bedtime. Treatment begins with 5 mg, and a caregiver accompanies the administration.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 5 mg · 10 mg

Donepezil can slow the heart rate and cause fainting or heart rhythm disturbances. Use with caution in patients with heart disease, prolonged QT interval, stomach ulcers, asthma, and seizures; do not combine with other cholinesterase inhibitors.

abfromà partir devanaf 69,20 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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Galantamine RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Galantamin

Delayed-release capsule containing acetylcholinesterase inhibitor for mild to moderate Alzheimer's dementia.

WirkeintrittOnsetDélai d’actionWerkingsaanvang
The effect is assessed over weeks to months.
WirkdauerDurationDurée d’actionWerkingsduur
once daily through delayed release
FormFormFormeVorm
Retard capsules

So wirkt es:How it works:Mode d’action :Zo werkt het: Galantamine inhibits the breakdown of the neurotransmitter acetylcholine in the brain, which is reduced in Alzheimer's disease. It also enhances the effect of acetylcholine at nicotinic receptors.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • If mild to moderate Alzheimer's dementia has been medically diagnosed
  • If galantamine is already being prescribed by a specialist and is well tolerated
  • If a caregiver monitors the daily intake
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: A sustained-release capsule for oral use, taken once daily in the morning with breakfast. The dose will be gradually increased by a doctor over several weeks.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 8 mg · 16 mg · 24 mg

Not suitable for patients with severe liver dysfunction or severely impaired kidney function. Use with caution if you have a slow pulse or heart rhythm disorders.

abfromà partir devanaf 51,48 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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Memantine (NMDA antagonist)

It reduces the excessive effect of the neurotransmitter glutamate and is intended for moderate to severe Alzheimer's disease.

memantine RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Ebixa (Memantin)

Memantine tablet for the treatment of moderate to severe Alzheimer's disease in adults.

WirkeintrittOnsetDélai d’actionWerkingsaanvang
The effect is assessed over weeks to months.
WirkdauerDurationDurée d’actionWerkingsduur
Once daily, half-life approximately 60 to 100 hours
FormFormFormeVorm
Film-coated tablets

So wirkt es:How it works:Mode d’action :Zo werkt het: Memantine blocks NMDA receptors for the neurotransmitter glutamate in the brain. This reduces pathologically elevated glutamate activity, which can disrupt signal transmission between nerve cells.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • If a moderate to severe Alzheimer's disease has been medically diagnosed
  • If memantine is already being prescribed by a specialist and is well tolerated
  • If a caregiver monitors the daily intake
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: Film-coated tablet for oral use, once daily at the same time. The dose is gradually increased at the beginning and determined by a doctor.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 10 mg · 20 mg

Caution is advised in patients with epilepsy and impaired kidney function. Do not use in combination with amantadine, ketamine, or dextromethorphan.

abfromà partir devanaf 66,67 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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RatgeberGuideGuideGids

What you should know about Alzheimer's dementia

Alzheimer's disease usually progresses slowly over years. Antidementia drugs can treat the symptoms, but they do not replace personal, in-person medical care.

What is Alzheimer's dementia?

Dementia is a progressive loss of cognitive abilities that significantly impacts daily life. Alzheimer's disease is the most common cause. In this disease, nerve cells in the brain gradually die, and neurotransmitters such as acetylcholine decrease. Typical symptoms include:

  • Forgetting new information, appointments, or conversations
  • Difficulties with orientation, language, and planning
  • Changes in mood, drive and behavior

Not every instance of forgetfulness is dementia. Depression, thyroid problems, vitamin deficiencies, or medications can also cause similar symptoms. Therefore, a personal examination is always the first step.

How do anti-dementia drugs work?

Antidementia drugs treat the symptoms but do not stop the progression of the disease. Their effectiveness becomes apparent over weeks to months and is regularly monitored by a doctor.

  • Donepezil: One tablet in the evening, for mild to moderate Alzheimer's dementia
  • Galantamine: Delayed-release capsule in the morning, for mild to moderate Alzheimer's dementia
  • Memantine (Ebixa): Film-coated tablet once daily, for moderate to severe Alzheimer's disease

The dose is increased gradually at the beginning. Donepezil and galantamine are not taken together because they belong to the same class of drugs.

Side effects and cautions

Nausea, vomiting, diarrhea, loss of appetite, dizziness, and muscle cramps are common side effects of donepezil and galantamine, especially at the beginning of treatment and after a dose increase. Both can slow the heart rate, which may lead to falls or fainting. Caution is advised in patients with, among other things, heart rhythm disorders, stomach ulcers, asthma, and seizures.

Memantine can cause dizziness, headache, drowsiness, constipation, and high blood pressure. A lower dose may be necessary in patients with impaired kidney function.

Inform the treatment team about taking donepezil or galantamine before undergoing surgery with anesthesia.

When immediate medical help is needed

Call emergency services immediately on 112 (Switzerland: 144) in the following cases:

  • Fainting, very slow or irregular heartbeat, or chest pain
  • a seizure, sudden paralysis or speech disorders
  • Vomiting blood or high fever with muscle stiffness and drowsiness
  • Thoughts of taking one's own life

Seek medical attention the same day if you experience sudden, severe confusion, black stools, persistent vomiting with little fluid intake, or a rash with blisters. For slowly progressing symptoms, a prompt appointment with your family doctor is recommended.

Everyday life with dementia

Careful monitoring of intake

In dementia, medications are easily forgotten or taken twice. Therefore, the product information for all three medications recommends that a caregiver monitors regular intake, for example, a family member, a home care service, or a nursing home staff member. Established routines provide security and ease the burden of daily life.

  • A weekly dosage box and a checklist for taking the medication prevent forgotten or double doses.
  • Note your weight, pulse, and any changes in sleep, mood, or behavior, and bring them with you for review.
  • Carry an up-to-date medication plan with you, including over-the-counter medications such as cough syrups.

Whether the treatment continues to be effective is regularly checked at a specialist's or general practitioner's office. Exercise, social contacts, and good blood pressure and blood sugar control are also part of preventative healthcare. Family members can find support, for example, at counseling centers, self-help groups, and home care services. More on the topic of blood pressure: Hypertension. Our online doctor answers general questions..

Zu den BehandlungsoptionenView treatment optionsVoir les options de traitementNaar de behandelopties

AblaufHow it worksDéroulementWerkwijze

In vier Schritten zur BehandlungFour steps to your treatmentEn quatre étapes vers votre traitementIn vier stappen naar uw behandeling

Ärztlich geprüft, diskret und ohne Wartezimmer.Reviewed by a doctor, discreet and without a waiting room.Examiné par un médecin, discret et sans salle d’attente.Door een arts beoordeeld, discreet en zonder wachtkamer.

  1. 1Behandlung wählenChoose a treatmentChoisir un traitementBehandeling kiezenWählen Sie Ihr Anliegen und das gewünschte Präparat oder stellen Sie eine allgemeine Anfrage.Choose your concern and the medicine you want, or send a general request.Choisissez votre problème et le médicament souhaité, ou envoyez une demande générale.Kies uw klacht en het gewenste middel, of stuur een algemene aanvraag.
  2. 2Fragebogen ausfüllenFill in the questionnaireRemplir le questionnaireVragenlijst invullenDie medizinischen Fragen beantworten Sie online, vertraulich und in Ruhe.You answer the medical questions online, confidentially and at your own pace.Vous répondez aux questions médicales en ligne, en toute confidentialité et à votre rythme.U beantwoordt de medische vragen online, vertrouwelijk en in alle rust.
  3. 3Ärztliche PrüfungMedical reviewÉvaluation médicaleMedische beoordelingEin zugelassener Arzt prüft Ihre Angaben. Ist die Behandlung nicht geeignet, erhalten Sie Ihr Geld zurück.A licensed doctor reviews your answers. If the treatment is not suitable, you get your money back.Un médecin agréé examine vos réponses. Si le traitement ne convient pas, vous êtes remboursé.Een bevoegde arts beoordeelt uw gegevens. Is de behandeling niet geschikt, dan krijgt u uw geld terug.
  4. 4Diskreter VersandDiscreet deliveryLivraison discrèteDiscrete verzendingNach Ausstellung des Rezepts versendet eine EU-Partnerapotheke Ihr Arzneimittel meist innerhalb eines Werktages.Once the prescription has been issued, an EU partner pharmacy usually sends your medicine within one working day.Une fois l’ordonnance établie, une pharmacie partenaire de l’UE expédie votre médicament généralement sous un jour ouvré.Na het uitschrijven van het recept verstuurt een EU-partnerapotheek uw geneesmiddel meestal binnen één werkdag.

Häufige FragenFrequently asked questionsQuestions fréquentesVeelgestelde vragen

Questions about Alzheimer's treatment

Haben Sie eine andere Frage? Unsere Ärzte und unser Service-Team helfen Ihnen gerne weiter.Have another question? Our doctors and our service team will be glad to help.Vous avez une autre question ? Nos médecins et notre équipe de service vous aident volontiers.Heeft u een andere vraag? Onze artsen en ons serviceteam helpen u graag verder.

Frage an einen ArztAsk a doctorPoser une question à un médecinVraag stellen aan een arts
Do I need a prescription for anti-dementia drugs?

Yes. Donepezil, galantamine, and Ebixa (memantine) are prescription medications. A medically diagnosed Alzheimer's dementia is required. A licensed physician will review the questionnaire to determine if a prescription is medically appropriate. A doctor's letter including the diagnosis, severity level, and current dosage, which can be uploaded with the questionnaire, is helpful.

Yes, this is often helpful in cases of dementia. Ideally, the affected person should complete the questionnaire together with a trusted caregiver. If it is completed on their behalf, advance directives or legal guardianship and the affected person's consent should be clarified. All questions refer to the person who is to take the medication.

Diagnosis and initiation of treatment should be carried out by a physician experienced in dementia, for example, in a neurology practice or memory clinic. Online treatment focuses on continuing an existing course of treatment. Initiating treatment requires a specialist referral. If only memory problems exist without a diagnosis, an in-person examination is necessary first.

Donepezil and galantamine belong to the same class of drugs and should not be taken at the same time. Memantine works via a different mechanism; whether a combination with a cholinesterase inhibitor is appropriate will be determined by your doctor. Drug interactions are also important, for example, with beta-blockers or cough suppressants containing dextromethorphan. Therefore, please list all medications you are taking in the questionnaire.

In that case, no prescription will be issued, and you will receive a full refund of all payments made. For memory problems without a confirmed diagnosis, or to begin treatment, we recommend scheduling an appointment with your family doctor, a neurologist, or a memory clinic. In case of warning signs such as fainting or a seizure, call emergency services immediately.

Medizinische ExpertiseMedical expertiseExpertise médicaleMedische expertise

Jede Anfrage in ärztlichen HändenEvery request in a doctor’s handsChaque demande entre des mains médicalesElke aanvraag in medische handen

Dr. Viktor Simunovic
Medizinischer GutachterMedical assessorMédecin évaluateurMedisch beoordelaarDr. Viktor SimunovicAllgemeinmedizin & digitale GesundheitGeneral medicine & digital healthMédecine générale et santé numériqueHuisartsgeneeskunde en digitale zorg
Dr. Codruta Anca Pandalache
Medizinische GutachterinMedical assessorMédecin évaluatriceMedisch beoordelaarDr. Codruta Anca PandalacheReproduktionsmedizin & FrauengesundheitReproductive medicine & women’s healthMédecine de la reproduction et santé des femmesVoortplantingsgeneeskunde en vrouwengezondheid
Lernen Sie unsere Ärzte kennenMeet our doctorsFaites connaissance avec nos médecinsMaak kennis met onze artsenHintergrund, Erfahrung und FachgebieteBackground, experience and specialismsParcours, expérience et spécialitésAchtergrond, ervaring en vakgebieden

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