Can you take Aricept and memantine together? Unpacking the Combination Therapy for Alzheimer's

October 10, 2025 •

2 min read

According to the Alzheimer's Association, millions of people in the United States live with Alzheimer's disease, and its prevalence is projected to increase significantly. For those with moderate to severe symptoms, a doctor may prescribe a combination of two medications, Aricept and memantine, to help manage cognitive and behavioral symptoms.

Quick Summary

Taking Aricept and memantine together is a common, FDA-approved approach for moderate to severe Alzheimer's disease, offering enhanced cognitive and functional benefits due to their complementary actions.

Key Points

FDA-Approved Combination: Aricept (donepezil) and memantine are FDA-approved to be taken together for moderate to severe Alzheimer's disease.
Complementary Mechanisms: Donepezil increases acetylcholine levels, while memantine regulates glutamate to protect neurons, offering complementary therapeutic effects.
Superior Efficacy: Clinical evidence shows the combination provides greater benefits for cognitive function, daily activities, and behavioral symptoms than donepezil alone.
Available as a Single Pill: A fixed-dose combination, Namzaric, simplifies administration by combining both drugs into one capsule.
Delayed Disease Progression: Studies indicate that dual therapy may delay the progression of the disease, including slowing cognitive decline and delaying nursing home placement.
Requires Medical Supervision: The decision to use combination therapy and management of potential side effects, such as dizziness or slow heart rate, must be overseen by a doctor.

The Rationale for Combination Therapy

Yes, Aricept (donepezil) and memantine are frequently prescribed together for patients with moderate to severe Alzheimer's disease. The FDA-approved, once-daily combination capsule, Namzaric, specifically contains an extended-release version of memantine and donepezil. This combination is based on the distinct ways these medications work to address Alzheimer's.

Aricept (donepezil) is an acetylcholinesterase inhibitor that increases acetylcholine levels in the brain, improving cognitive function. Memantine is an NMDA receptor antagonist that protects neurons from damage caused by excessive glutamate activity.

Clinical Evidence for Efficacy

Research indicates that combining donepezil and memantine can offer benefits for moderate to severe Alzheimer's.

Improved Cognitive Function: Studies suggest better cognitive outcomes with combination therapy compared to donepezil alone in more severely impaired patients.
Enhanced Daily Function: Combination therapy can improve a patient's ability to perform activities of daily living.
Stabilized Behavioral Symptoms: Research suggests the combination can help manage behavioral symptoms.
Delayed Institutionalization: Dual therapy has been found to delay the time to nursing home admission.

Potential Side Effects and Safety Considerations

While generally safe, the combination of donepezil and memantine can have side effects. A healthcare provider will evaluate risks and benefits.

Common side effects include:

Nausea and vomiting
Diarrhea
Dizziness and headache

Less common but serious side effects can include:

Bradycardia (slow heart rate)
Gastrointestinal bleeding
Seizures

Monitoring and reporting any concerning symptoms are crucial.

Comparison of Monotherapy and Combination Therapy for Alzheimer's Disease


Feature	Donepezil Monotherapy (Mild-Moderate AD)	Memantine Monotherapy (Moderate-Severe AD)	Combination Therapy (Donepezil + Memantine)
Mechanism of Action	Acetylcholinesterase inhibitor	NMDA receptor antagonist	Combines both mechanisms
Primary Indication	Mild, moderate, and severe AD	Moderate to severe AD	Moderate to severe AD
Symptom Focus	Cognitive symptoms	Behavior, function	Cognitive, functional, behavioral symptoms
Efficacy	Slows cognitive/functional decline	Improves behavior/stabilizes function	Often provides superior benefits
Common Side Effects	Nausea, diarrhea, insomnia	Dizziness, headache, constipation	Dizziness, headache, nausea, diarrhea

The Importance of Medical Guidance

Discussing any Alzheimer's treatment, including combination therapy, with a healthcare professional is vital. They can tailor the treatment plan, considering the patient's stage of disease, health, and potential drug interactions. Following medical advice and monitoring for side effects are essential.

Combination therapy manages symptoms and slows decline but does not cure Alzheimer's. Realistic expectations and regular follow-ups are important.

Conclusion

Combining Aricept and memantine is a standard treatment for moderate to severe Alzheimer's, offering comprehensive benefits by targeting different disease aspects. The availability of Namzaric simplifies this approach. Medical guidance is crucial for safe and effective use.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult a qualified healthcare professional before making any decisions about your treatment.

Frequently Asked Questions

The fixed-dose combination of extended-release memantine and donepezil is called Namzaric, which the FDA has approved for patients with moderate to severe Alzheimer's disease.

Aricept (donepezil) increases levels of the neurotransmitter acetylcholine, while memantine blocks excess glutamate, which can be toxic to neurons. Their different mechanisms of action complement each other to improve symptoms.

Clinical trials for moderate to severe Alzheimer's disease suggest that combining donepezil and memantine can provide greater benefits for cognition, function, and behavior than donepezil monotherapy.

Common side effects may include dizziness, headache, nausea, diarrhea, and vomiting. Most side effects are mild and tend to decrease over time.

Serious but rare side effects can include a dangerously slow heart rate (bradycardia), seizures, or signs of gastrointestinal bleeding such as bloody or tarry stools. Any such symptoms should be reported to a doctor immediately.

Evidence for the benefit of combination therapy in mild Alzheimer's disease is limited, and it is primarily indicated for patients with moderate to severe symptoms.

A doctor may start a patient on donepezil during the earlier stages of the disease. If symptoms progress to moderate or severe, memantine may be added. Dosing is often started low and gradually increased.

No, neither Aricept nor memantine, alone or in combination, can cure Alzheimer's disease. The goal of treatment is to manage symptoms, slow the rate of decline, and maintain quality of life.