[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Cholinesterase inhibitors](https://durgical.com/en/pharmacology/classes/cholinesterase-inhibitors/) › Galantamine

[Pharmacology](https://durgical.com/en/pharmacology/) · [Cholinesterase inhibitors](https://durgical.com/en/pharmacology/classes/cholinesterase-inhibitors/)

# Galantamine

A reversible cholinesterase inhibitor for mild to moderate Alzheimer dementia, with side effects like those of donepezil.

Updated 2026-11-01

- Class: [Cholinesterase inhibitors](https://durgical.com/en/pharmacology/classes/cholinesterase-inhibitors/)
- Enzyme: Acetylcholinesterase
- ATC code: N06DA04

✂**Acetylcholinesterase**Galantamine

ⓘ The figure shows (-)-galantamine bound at the bottom of the gorge of human acetylcholinesterase, next to the catalytic site.

**Target in 3D:** Acetylcholinesterase. PDB structure 4EY6 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4EY6) · Drag to rotate · pinch to zoom

## Mechanism of action

Galantamine is a reversible, competitive inhibitor of acetylcholinesterase that enters the brain. By slowing the breakdown of acetylcholine released by the surviving cholinergic neurons, it can improve memory and daily function for a time in Alzheimer disease.

- Enters the brain
- Competes with acetylcholine at the enzyme's active site
- Acetylcholine lasts longer at synapses
- Cognitive symptoms improve modestly

## Pharmacokinetics

**Metabolism**
In the liver by CYP2D6 and CYP3A4; inhibitors of these enzymes raise its levels modestly

**Elimination**
Several metabolic routes plus the kidney, which removes part of it unchanged

**Half-life**
Terminal half-life about 7 hours

## Indications

- Mild to moderate dementia of the Alzheimer type [Alzheimer disease →](https://durgical.com/en/conditions/alzheimer-disease/)

## Adverse effects

### Common

- Nausea, vomiting, diarrhoea and loss of appetite
- Weight loss
- Dizziness and headache

### Serious (rare, important)

- Stevens-Johnson syndrome and acute generalized exanthematous pustulosis
- Bradycardia and all types of heart block
- Gastrointestinal bleeding
- Seizures; bladder outflow obstruction

## Contraindications

- Hypersensitivity to galantamine or its excipients
- Severe liver impairment (use not recommended)

## Key interactions

**CYP2D6 inhibitors (fluoxetine, paroxetine, quinidine)**
Slower clearance and higher galantamine levels

**Anticholinergic drugs**
Opposite effects

**Succinylcholine**
Exaggerated muscle relaxation in anaesthesia

## What is monitored

- Heart rate and fainting
- Weight and hydration
- Skin: any rash
- Breathing in people with severe asthma or COPD

## Administration and safety

- Taken with meals, with good fluid intake
- Doses are increased gradually; after a break of more than three days, treatment restarts at the lowest dose

## Nursing care

- Teach caregivers to stop and report at the first skin rash
- Check pulse and ask about fainting
- Encourage fluids to prevent dehydration

## Pregnancy and breastfeeding

No adequate data in pregnancy; it is used mainly in older adults.

## Memory aid

GALantamine: a «gentle» reversible blocker, but stop at the first rash (SJS).

## Test yourself

Think of the answer, then tap the question to see it.

## Which serious skin reactions are listed for galantamine?

Stevens-Johnson syndrome and acute generalized exanthematous pustulosis; the drug is stopped at the first rash unless clearly unrelated.

## Which liver enzymes metabolize galantamine?

CYP2D6 and CYP3A4.

## Is galantamine a reversible or a carbamylating inhibitor?

Reversible and competitive, like donepezil; rivastigmine is the carbamylating one.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/galantamine/)

## Related drugs

- [Donepezil](https://durgical.com/en/pharmacology/donepezil/)
- [Rivastigmine](https://durgical.com/en/pharmacology/rivastigmine/)

## Related conditions

- [Alzheimer disease](https://durgical.com/en/conditions/alzheimer-disease/)

[← Back to the class: Cholinesterase inhibitors](https://durgical.com/en/pharmacology/classes/cholinesterase-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - GALANTAMINE tablet, film coated](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=10497273-d907-0514-e063-6294a90a1362) (DailyMed (U.S. National Library of Medicine), 2026); [Galantamine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a699058.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [RCSB PDB - 4EY6: Crystal Structure of Recombinant Human Acetylcholinesterase in Complex with (-)-galantamine](https://www.rcsb.org/structure/4EY6) (RCSB Protein Data Bank, 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 21 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/galantamine/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/galantamine/