Tacrine Hydrochloride, Oral

Type of medicine: acetylcholinesterase inhibitor

Generic and brand names: tacrine hydrochloride, oral; Cognex

This medicine is taken by mouth to treat symptoms of Alzheimer's-type dementia.

Before taking this medicine, tell your health care provider if you have ever had:

• an allergic reaction to any medicine
• asthma or other breathing problems
• liver disease
• kidney disease
• heart disease or heart attack
• Parkinson's disease
• seizures
• stomach ulcers
• trouble urinating.

Females of childbearing age: Tell your health care provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your health care provider's approval.

Take this medicine exactly as your health care provider prescribes. Your provider may adjust the dosage to find the one that is best. Do not take more or less or take it longer than prescribed. Do not stop taking this medicine without your health care provider's approval. Changing your dosage may cause a serious decline in your ability to think and control your behavior.

Take this medicine on an empty stomach. If the medicine causes stomach upset, you may take it with meals. Follow your health care provider's directions exactly.

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your health care provider.

This medicine may cause urinary problems. If you have trouble urinating, contact your health care provider right away.

You will need to have blood tests regularly to see how this medicine affects your liver. Keep all appointments for these tests.

If you need emergency care, surgery, or dental work, tell the health care provider or dentist you are taking this medicine.

Smoking tobacco may lower the blood levels of this medicine. If you smoke, your health care provider may need to change the dosage of your medicine.

People who have Alzheimer's disease should not be allowed to drive, operate machinery, or perform other hazardous tasks. This medicine may cause dizziness and confusion, which can add to the problems caused by the disease itself.

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your health care provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your health care provider right away. If you cannot reach your health care provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your health care provider right away): Seizures (convulsions), chest pain, yellowing of skin or eyes, changes in stool color (black or light color), fast or irregular heartbeat, trouble urinating, severe nausea or vomiting, extreme weakness.

Other: Nausea, vomiting, loose stools, diarrhea, headache, dizziness, confusion, drowsiness, poor appetite, muscle pain, anxiety, trouble sleeping.

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your health care provider if you are taking:

• anticholinergic medicines such as benztropine (Cogentin), dicyclomine (Bentyl), atropine sulfate, belladonna, propantheline (Pro-Banthine), methscopolamine (Pamine), l-hyoscyamine (Levsin, Levsinex), amantadine (Symmetrel), procyclidine (Kemadrin), and trihexyphenidyl (Artane)
• beta blockers such as atenolol (Tenormin), carteolol (Cartrol), pindolol (Visken), metoprolol (Lopressor, Toprol), timolol (Blocadren), nadolol (Corgard), and propranolol (Inderal)
• cholinergic medicines such as bethanechol (Urecholine), neostigmine (Prostigmin), and pyridostigmine (Mestinon)
• cimetidine (Tagamet)
• fluvoxamine (Luvox)
• levodopa (Sinemet)
• NSAIDs such as ibuprofen (Motrin, Motrin IB, Advil, Nuprin), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), ketoprofen (Orudis, Orudis KT, Oruvail), nabumetone (Relafen), indomethacin (Indocin), ketorolac (Toradol), sulindac (Clinoril), piroxicam (Feldene), diclofenac (Voltaren, Cataflam), and oxaprozin (Daypro)
• theophylline.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all health care providers who treat you about all the products you are taking.

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your health care provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.