Cognitine Special Precautions

Patients with epilepsy.
Simultaneous use of medications with active ingredients such as amantadine, ketamine, dextromethorphan as well as other NMDA (N-methyl-D-aspartate) antagonists should be avoided.
Some factors that may raise urine pH may necessitate careful monitoring of the patient. These factors include drastic changes in diet, e.g. from a carnivore to a vegetarian diet, or a massive ingestion of alkalising gastric buffers. Also, urine pH may be elevated by states of renal tubulary acidosis (RTA) or severe infections of the urinary tract with Proteus bacteria.
Patients who have recently suffered a myocardial infarction (heart attack) or from under-compensated cardiac insufficiency or untreated high blood pressure.
Moderate to severe Alzheimer's disease usually causes impairment of driving performance and compromises the ability to use machinery. Furthermore, Memantine has minor or moderate influence on the ability to drive and use machines, such that outpatients should take special care.
Use in Children: Memantine is not recommended for use in children below 18 years due to a lack of data on safety and efficacy.