Dosing and uses of Cognex (tacrine)
Adult dosage forms and strengths
capsule
- 10mg
- 20mg
- 30mg
- 40mg
Alzheimer's Dementia
10-20 mg PO QID; no more than 160 mg/day
Monitor LFTs every other week from weeks 4-16, then q3Months
Take between meals, unless GI upset
Hepatic Impairment
LFTs >3-5x upper limit of normal, reduce dose to 10mg PO QID, monitor LFT's qWeek, resume dose titration and qoWeek monitoring when ALT return to normaL
LFT's >5x upper limit of normal, stop treatment monitor for symptom hepatitis, follow ALT until WNL's and rechallenge with initial dose 10 mg PO QID, monitor LFT's qweek, if after 6 weeks ALT wnl's may retry dose titration schedule, continue qweek ALT monitoring for 16 weeks then qmonths for 2 months then q3Months thereafter
Pediatric dosage forms and strengths
<18 years old: Safety & efficacy not established
Cognex (tacrine) adverse (side) effects
>10%
Incr LFT's (26-30%)
Nausea/vomiting (26-30%)
Diarrhea (15-20%)
Headache (11-15%)
Dizziness (11-15%)
1-10%
Dyspepsia (6-10%)
Anorexia (6-10%)
Abdominal pain (6-10%)
Myalgia (6-10%)
Confusion (6-10%)
Ataxia (6-10%)
Insomnia (6-10%)
Rhinitis (6-10%)
Rash (6-10%)
Fatigue (1-5%)
Weight loss (1-5%)
Constipation (1-5%)
Somnolence (1-5%)
Tremor (1-5%)
Anxiety (1-5%)
Warnings
Contraindications
Hypersensitivity
Drug-induced bilirubin >3 mg/dL [51.3 umol/L]
Pregnancy and lactation
Pregnancy category: C
Lactation: unknown
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Cognex (tacrine)
Half-Life: 2-4 hr
Peak Plasma Time: 1-2 hr
Bioavailability: 17%
Protein Bound: 55%
Vd: 349 L
Metabolism: hepatic P450 enzyme CYP1A2
Enzymes inhibited: CYP1A2
Mechanism of action
Centrally acting cholinesterase inhibitor
