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Nivalin

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Doctor

Tomasz Grzelewski

Dermatology20 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use Nivalin

Package Leaflet: Information for the Patient

Warning! Keep the Leaflet! Information on the Immediate Packaging in a Foreign Language.

Nivalin, 5 mg/ml, Solution for Injection

Galantamine Hydrobromide

Read the Leaflet Carefully Before Using the Medicinal Product, as it Contains Important Information for the Patient.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicinal product has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
  • If you experience any side effects, including those not listed in this leaflet, please inform your doctor or nurse. See section 4.

Table of Contents of the Leaflet:

  • 1. What is Nivalin and What is it Used For
  • 2. Important Information Before Using Nivalin
  • 3. How to Use Nivalin
  • 4. Possible Side Effects
  • 5. How to Store Nivalin
  • 6. Contents of the Pack and Other Information

1. What is Nivalin and What is it Used For

Nivalin is a medicinal product containing galantamine - an alkaloid isolated from snowdrops.
Galantamine belongs to a group of medicinal products called acetylcholinesterase inhibitors.
It increases the concentration of a chemical compound called acetylcholine, which participates in the transmission of nerve impulses in the central and peripheral nervous system.
Nivalin is used in the symptomatic treatment of neurological diseases, neuromuscular and spinal cord diseases.

2. Important Information Before Using Nivalin

When Not to Use Nivalin

  • if you are allergic to the active substance or any of the other ingredients of this medicinal product (listed in section 6) - if you have asthma (breathing difficulties),
  • if you have a slow heart rate (bradycardia) or conduction disorders (atrioventricular block),
  • if you have coronary heart disease (insufficient blood supply to the heart muscle) or severe heart failure (impaired heart function),
  • if you have epilepsy,
  • if you have excessive motor activity (movement),
  • if you have severe kidney or liver failure.

Warnings and Precautions

Before starting to use Nivalin, discuss it with your doctor:

  • if you have sick sinus syndrome (disrupted formation of electrical impulses in the heart), prolonged QTc interval or other conduction disorders in the heart;
  • if you are taking other medicinal products that may slow down your heart rate (digoxin, beta-adrenergic receptor blockers);
  • if you have high or low potassium levels in your blood;
  • if you have symptoms of Parkinson's disease (tremors, stiffness, mask-like face, slow movements and shuffling gait);
  • if you have severe respiratory disease (obstructive pulmonary disease);
  • if you have moderate kidney failure or urinary tract obstruction, if you have recently undergone surgical treatment of the prostate or bladder, as well as during surgical operations under general anesthesia. If you experience excessive weight loss during treatment with Nivalin, it should be monitored.

Nivalin and Other Medicinal Products

Tell your doctor about all the medicinal products you are taking or have recently taken, as well as any medicinal products you plan to take.
Some medicinal products may increase the likelihood of side effects in people taking Nivalin. These include: anti-arrhythmic or anti-hypertensive medicinal products (quinidine, digoxin, beta-adrenergic receptor blockers, e.g. atenolol, propranolol); medicinal products affecting the QTc interval; antibiotics (gentamicin, amikacin, erythromycin); antidepressants (paroxetine, fluoxetine); ketoconazole (treatment of fungal infections); ritonavir (treatment of AIDS).

Pregnancy and Breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicinal product.

Driving and Using Machines

Nivalin may cause vision disturbances, dizziness and drowsiness, which may affect your ability to drive and use machines.

Nivalin Contains Sodium

This medicinal product contains less than 1 mmol (23 mg) of sodium per 1 ml of solution, which means that it is considered to be "sodium-free".

3. How to Use Nivalin

Nivalin is available in a dose of 2.5 mg/ml and 5 mg/ml.
Nivalin is administered by qualified medical personnel under medical supervision.
The dosage and duration of treatment are determined by the doctor, depending on the type and severity of the disease.
Nivalin, solution for injection, is administered subcutaneously, intramuscularly or intravenously. If the doctor does not recommend otherwise, the following dosage is recommended:

Treatment of Neurological Diseases

Use in Adults

The recommended initial dose is 2.5 mg. Every 3-4 days, the dose is gradually increased by 2.5 mg in 2 or 3 divided doses. The maximum single dose in adults is 10 mg subcutaneously, and the maximum daily dose is 20 mg.

Use in Children and Adolescents

Nivalin is administered subcutaneously in doses determined by the doctor, depending on the child's age.
The medicinal product is administered subcutaneously in the following daily doses:
from 1 to 2 years
0.25 - 1.0 mg
from 3 to 5 years
0.50 - 5.0 mg
from 6 to 8 years
0.75 - 7.5 mg
from 9 to 11 years 1.0 - 10.0 mg
from 12 to 15 years 1.25 - 12.5 mg
over 15 years 1.25 - 15.0 mg
The duration of treatment depends on the nature and severity of the treated disease. Most often 40 to 60 days.
Treatment cycles can be repeated 2-3 times at intervals of 1-2 months.

Use of a Higher Than Recommended Dose of Nivalin

The medicinal product is administered by qualified medical personnel, so its overdose is unlikely. Nevertheless, suspected overdose should be reported to the doctor.
In case of doubts related to the use of the medicinal product, consult a doctor.

4. Possible Side Effects

Like all medicinal products, Nivalin can cause side effects, although not everybody gets them.
Nivalin may slow down your heart rate or cause irregular heartbeat, chest pain, palpitations, nausea, vomiting, diarrhea, increased peristalsis, abdominal pain. Sometimes, high or low blood pressure is observed. Other symptoms include: narrowed pupils, increased sweating and salivation, as well as excessive discharge from the nose, tear glands and bronchi, insomnia, muscle cramps, dizziness, headaches, rapid breathing and respiratory disorders. Loss of appetite and weight loss have been reported. Some patients may experience allergic reactions, including itching, skin rash, urticaria, rhinitis. In individual cases, severe hypersensitivity reactions with loss of consciousness have been observed.

Reporting Side Effects

If you experience any side effects, including those not listed in this leaflet, please inform your doctor or nurse.
Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: + 48 22 49 21 301, fax: + 48 22 49 21 309, website: https://smz.ezdrowie.gov.pl.
By reporting side effects, you can help provide more information on the safety of this medicinal product.

5. How to Store Nivalin

Keep the medicinal product out of the sight and reach of children.
Store in a temperature below 25°C. Store in the original packaging to protect from light. Do not freeze.
Do not use Nivalin after the expiry date stated on the packaging. The expiry date refers to the last day of the month.
Medicinal products should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicinal products that are no longer needed. This will help protect the environment.

6. Contents of the Pack and Other Information

What Nivalin Contains

  • The active substance of the medicinal product is galantamine hydrobromide.
  • The other ingredients are: sodium chloride and water for injections.

What Nivalin Looks Like and Contents of the Pack

1 ampoule of 1 ml contains 5 mg of galantamine hydrobromide.
Nivalin, solution for injection, is a clear, colorless or pale yellow liquid.

Packaging:

Ampoules made of colorless glass in a PVC blister.
1 blister placed in a cardboard box with a patient leaflet.

Pack Size:

1 blister of 10 ampoules, in a cardboard box.
To obtain more detailed information, please contact the marketing authorization holder or the parallel importer.

Marketing Authorization Holder in Latvia, the Country of Export:

Sopharma AD
16, Iliensko Shosse Str.
1220 Sofia
Bulgaria

Manufacturer:

Sopharma AD
16, Iliensko Shosse Str.
1220 Sofia
Bulgaria

Parallel Importer:

InPharm Sp. z o.o.
ul. Strumykowa 28/11
03-138 Warsaw

Repackaged by:

InPharm Sp. z o.o. Services sp. k.
ul. Chełmżyńska 249
04-458 Warsaw
Marketing Authorization Number in Latvia, the Country of Export:06-0145
Parallel Import Authorization Number:91/18
Date of Approval of the Leaflet: 13.02.2023
[Information about the Trademark]

Alternatives to Nivalin in other countries

The best alternatives with the same active ingredient and therapeutic effect.

Alternative to Nivalin in Ukraina

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Alternative to Nivalin in Hiszpania

Dosage form: TABLETKA, 60 mg
Active substance: pyridostigmine
Prescription required

Online doctors for Nivalin

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for Nivalin – subject to medical assessment and local rules.

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Svetlana Kovalenko

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Dr Svetlana Kovalenko is a family medicine doctor with over 14 years of experience and a medical degree from Kharkiv National Medical University. She offers online consultations for adults, supporting patients with both acute and chronic conditions, preventive care, and personalised medical advice.

What patients commonly consult her for:

  • High blood pressure, type 2 diabetes, cholesterol management
  • Cold and flu symptoms: fever, cough, sore throat
  • Fatigue, sleep problems, headaches, general discomfort
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  • Help interpreting test results and lab reports
  • Preventive check-ups and advice on healthy lifestyle habits

Dr Kovalenko combines evidence-based practice with a respectful, patient-centred approach. She takes time to explain, listens attentively, and helps each person make confident, informed decisions about their health.

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Tomasz Grzelewski

Dermatology20 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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  • Respiratory symptoms: colds, flu, sore throat, cough, fever.
  • Digestive issues: heartburn, bloating, constipation, IBS symptoms.
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  • Cardiovascular disease prevention and metabolic risk reduction.
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Dr Kolomeeva combines clinical expertise with personalised care. She clearly explains diagnoses, guides patients through symptoms and treatment options, and provides actionable plans. Her consultations are designed not only to address current complaints but also to stabilise chronic conditions and prevent future complications. She supports patients through every stage of care – from first symptoms to ongoing health management.

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Cardiology – Diagnosis and treatment of:

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  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
  • Leg swelling, chronic fatigue, reduced exercise tolerance.
  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
  • Post-COVID-19 cardiac monitoring and care.
Endocrinology – Diabetes, thyroid, metabolism:
  • Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
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  • Metabolic syndrome – obesity, lipid disorders, insulin resistance.
Gastroenterology – Digestive health:
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  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
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  • Adult vaccinations – planning, contraindications assessment.
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Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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You can consult Dr. Ben Harbi for:

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  • Hypertension, type 1 and type 2 diabetes, metabolic issues.
  • Cold, cough, flu, respiratory infections, sore throat, fever.
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  • Skin rashes, mild allergic reactions, basic dermatological complaints.
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Dr. Ben Harbi offers reliable, accessible medical support through online consultations, helping patients make informed decisions about their health with a clear, structured, and compassionate approach.

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Dr. Tabeshadze combines extensive diagnostic experience with personalised care. She helps patients understand their cardiovascular health, navigate symptoms and diagnoses, and create tailored treatment plans to improve quality of life and reduce long-term risks.
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Consultations are available in English and Portuguese. Patients value his clarity, professionalism, and balanced approach to evidence-based care.

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Dr. Popov’s approach is rooted in evidence-based medicine, combined with individualised care tailored to each patient’s history, lifestyle, and clinical needs.

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