A fixed combination of 2 drugs in one pill.
Sold as Namzaric.
A combination is graded by its riskiest ingredient: each part of the score is the lowest of the ingredients' scores. This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.
Ingredients with a page of their own link to it: the FDA label, side-effect reports, recalls, evidence, and payments behind this grade are there.
Score breakdown (80/100)
Safety ×35%
B
Evidence ×25%
D
Regulatory ×15%
A
Money & lawsuits ×15%
A
Options ×10%
C
Safety: 82
Graded by its riskiest ingredient, memantine (82)
Listed by the independent review Prescrire as a drug to avoid (2026 edition) (-10)
651 FDA reports naming it as the suspect drug per million Medicare fills, 0.2x the median drug on this site
Death appears in 1.7x the share of reports seen across all of FAERS (-3)
Off-label use is among the five most-reported items: widely used beyond its approved evidence (-5)
Evidence: 61
Graded by its riskiest ingredient, donepezil (61)
294 randomized trials and 52 systematic reviews/meta-analyses indexed in PubMed
Prescrire's independent reviewers find its harm-benefit balance unfavourable versus alternatives (-10)
8 independent Cochrane review(s) exist
Only 39% of completed registered trials posted results (-8)
Regulatory history: 97
Graded by its riskiest ingredient, donepezil (97)
Recalls since 2016: 0 Class I, 2 Class II, 0 Class III across 47 generic makers (-3)
Money & lawsuits: 100
Graded by its riskiest ingredient, donepezil (100)
Pharma paid doctors $0 tied to this drug last year: negligible
Not named in any pending federal MDL
Options: 70
Graded by its riskiest ingredient, memantine (70)
Generic versions approved (43 applications)
No same-class alternatives found: little leverage to switch (-30)
Money and lawsuits
In 2024, drug companies reported $0 in payments to US physicians and hospitals tied to this combination's brands across 0 transactions.
No pending federal MDL names this combination or its brands.
The ingredients' own payments and lawsuits are on their pages and already count toward this grade.
Who takes it and what it costs
18,217Medicare Part D patients (2024)
129,758prescriptions filled
$691average cost per fill
$90Mtotal Medicare spend
Questions to ask your prescriber
This is a fixed combination of donepezil and memantine. Why both together, instead of only the one I need?
An independent reviewer (Prescrire) lists this as a drug to avoid because the harms outweigh the benefits versus alternatives. What is your view on that?
The most-reported problems in FDA's adverse event data are fall, death, diarrhoea, fatigue. How would we recognize and handle those?
Why this one over benzgalantamine, galantamine, rivastigmine? What would make you pick one of those instead?
What result are we expecting, by when, and what is the plan if it does not happen?
If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)
The most-reported problems in FDA's adverse event data are fall, death. How would we recognize and handle those?
Off-label use is among the most-reported items for this drug. Is my use on-label, and if not, what evidence supports it?