Tacrine: Side Effects and Dosing

What is tacrine, and how does it work (mechanism of action)?

  • Tacrine is an oral medication used to treat
    patients with Alzheimer's disease.
  • Tacrine is in a class of
    drugs called
    cholinesterase inhibitors that also includes
    rivastigmine (Exelon),
    (Aricept), and
    galantamine (Razadyne – formerly Reminyl). Cholinesterase
    inhibitors inhibit (block) the action of acetylcholinesterase, the enzyme
    responsible for the destruction of acetylcholine.
  • Acetylcholine is one of
    several neurotransmitters in the brain, chemicals that nerve cells use to
    communicate with one another. Reduced levels of acetylcholine in the brain are
    believed to be responsible for some of the symptoms of Alzheimer's disease. By
    blocking the enzyme that destroys acetylcholine, rivastigmine increases the
    concentration of acetylcholine in the brain, and this increase is believed to be
    responsible for the improvement in thinking seen with tacrine.
  • Tacrine was
    approved by the FDA in 1993.

Is tacrine available as a generic drug?


Do I need a prescription for tacrine?


What are the uses for tacrine?

Tacrine is used for the treatment of mild to
moderate dementia of the Alzheimer's type.

What are the side effects of tacrine?

The most common side effect of tacrine is an increase in
liver test called alanine aminotransferase (ALT) as a result of liver damage.
When a patient starts taking tacrine, blood is drawn on a weekly basis to
measure ALT. If there is an increase in blood ALT, the dosage of tacrine can be
reduced. Other side effects of tacrine include:

What is the dosage for tacrine?

  • The recommended dose is 10 to 20 mg four times daily.
  • The
    maximum dose is 160 mg daily.
  • Tacrine is usually taken on an empty stomach (one
    hour before, or two hours after meals) unless it causes stomach upset.

Which drugs or supplements interact with tacrine?

Drugs with anticholinergic properties and which
cross into the brain, such as atropine, benztropine (Cogentin), and
trihexyphenidyl (Artane) produce opposite effects of tacrine and should be
avoided during therapy with tacrine. Unlike donezepril (Aricept), tacrine does
not reduce the elimination of other drugs, increasing their levels in blood and
the likelihood of their side effects.

Is tacrine safe to take if I’m pregnant or breastfeeding?

Animal reproduction studies have not been done with tacrine.
It is not known if tacrine causes fetal harm when taken by a
pregnant woman. Tacrine may pass into
breast milk and be harmful to
the nursing infant; it should not be used while nursing.

What else should I know about tacrine?

What preparations of tacrine are available?

Capsules: 10, 20, 30, and 40 mg.

How should I keep tacrine stored?

Capsules should be stored at room temperature, 15-30 C (59-86

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