Tacrine (HCl)

It should be used only if clearly needed during pregnancy. It should be used with caution in patients with asthma, seizure disorder, epilapsy, heart disease such as hypertension, bradycardia, recent myocardial infraction, thyroid disorders, intestinal disorders, ulcers, urinary problems, impaired liver function or who have a history of such impairment or if have any allergy especially to bromides. Large dose by mouth should be avoided in condition where there may be increase absorption from the gastrointestinal tract. Serum-alanin aminotransferase concentrations should be monitored in patients receiving cintinuous treatment with tacrine. Monitoring should be carried out every other week for atleast the first first 16 weeks of therapy, followd by monthly for 2 months an dthen every 3 months thereafter. Weekly monitoring is recommended in patients with elevated aminotransferase levels that are greater than twice the upper limit of the normal range. If sign of liver involvment worsen, the dose should be reduced or withdrawn. Tacrine should be taken on an empty stomach to improve absorption. The initial dose is given for a minimum of 6 weeks. Dosage should not be increased during this period because the potential exists for a delay in onset of increased liver enzyme concentration. Serum-alanin aminotransferase concentrations should be monitored regularly and if there is no significant increase doses may be increased.