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Nivalin

Ask a doctor about a prescription for Nivalin

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Doctor

Dmytro Horobets

Family medicine6 years of experience

Dr. Dmytro Horobets is a licensed family medicine physician in Poland, specialising in endocrinology, diabetology, obesity management, gastroenterology, pediatrics, general surgery, and pain medicine. He offers online consultations for adults and children, providing personalised medical support for a wide range of acute and chronic health concerns.

Areas of expertise:

  • Endocrinology: diabetes type 1 and type 2, prediabetes, thyroid disorders, metabolic syndrome, hormonal imbalance.
  • Obesity medicine: structured weight management plans, nutritional counselling, obesity-related health risks.
  • Gastroenterology: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), liver and biliary conditions.
  • Pediatric care: infections, respiratory symptoms, digestive issues, growth and development monitoring.
  • General surgery support: pre- and post-surgical consultations, wound care, rehabilitation.
  • Pain management: chronic and acute pain, back pain, joint pain, post-traumatic pain syndromes.
  • Cardiovascular health: hypertension, cholesterol control, risk assessment for heart disease.
  • Preventive medicine: regular check-ups, health screenings, long-term management of chronic conditions.

Dr. Horobets combines evidence-based medicine with a patient-centred approach. He carefully evaluates each patient’s medical history and symptoms, offering clear explanations and structured treatment plans adapted to individual needs.

Whether you need help managing diabetes, tackling weight-related health issues, interpreting lab results, or receiving general family medicine support, Dr. Horobets provides professional online care tailored to your specific health goals.

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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 Ukraine

Dosage form: solution, 5 mg/ml per 1 ml
Manufacturer: PrAT "Lekhim - Harkiv
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Manufacturer: AT "Olajnfarm
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Dosage form: solution, 15mg/ml in 1ml ampoule
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Manufacturer: PAT "Kiivmedpreparat
Prescription required

Alternative to Nivalin in Spain

Dosage form: TABLET, 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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Katia Benko

Pediatrics9 years of experience

Dr Katia Benko is a paediatrician with over 9 years of clinical experience and international training. She completed her medical education and residency in Argentina and is fully licensed to practise in Spain. Her work spans newborns, children and adolescents, with a focus on whole-person care that integrates physical, emotional and developmental health.

Areas of expertise:

  • online consultations for newborns, children and teens
  • evaluation and treatment of acute symptoms: fever, cough, infections, bronchiolitis, earache, etc.
  • long-term care for chronic paediatric conditions
  • preventive care at every stage of growth and development
  • child wellness visits and routine health check-ups
  • vaccination guidance according to standard and special schedules
  • assessment of neurodevelopment in infants and toddlers
  • feeding concerns: picky eating, food refusal, healthy habits, eating disorders
  • parental support in everyday health, emotional wellbeing and prevention
  • guidance for teenagers on healthy habits, self-care and risk prevention
Dr Benko sees paediatrics as a space for partnership with families – not only to treat illness, but to guide each child’s health journey with clarity, empathy and trust. Her goal is for every family to feel supported in making confident, informed decisions for their child’s wellbeing.
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Dmytro Horobets

Family medicine6 years of experience

Dr. Dmytro Horobets is a licensed family medicine physician in Poland, specialising in endocrinology, diabetology, obesity management, gastroenterology, pediatrics, general surgery, and pain medicine. He offers online consultations for adults and children, providing personalised medical support for a wide range of acute and chronic health concerns.

Areas of expertise:

  • Endocrinology: diabetes type 1 and type 2, prediabetes, thyroid disorders, metabolic syndrome, hormonal imbalance.
  • Obesity medicine: structured weight management plans, nutritional counselling, obesity-related health risks.
  • Gastroenterology: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), liver and biliary conditions.
  • Pediatric care: infections, respiratory symptoms, digestive issues, growth and development monitoring.
  • General surgery support: pre- and post-surgical consultations, wound care, rehabilitation.
  • Pain management: chronic and acute pain, back pain, joint pain, post-traumatic pain syndromes.
  • Cardiovascular health: hypertension, cholesterol control, risk assessment for heart disease.
  • Preventive medicine: regular check-ups, health screenings, long-term management of chronic conditions.

Dr. Horobets combines evidence-based medicine with a patient-centred approach. He carefully evaluates each patient’s medical history and symptoms, offering clear explanations and structured treatment plans adapted to individual needs.

Whether you need help managing diabetes, tackling weight-related health issues, interpreting lab results, or receiving general family medicine support, Dr. Horobets provides professional online care tailored to your specific health goals.

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Dr. Karim Ben Harbi is a licensed general practitioner based in Italy. He provides online consultations for adults and children, combining international clinical experience with evidence-based medicine. His care approach is focused on accurate diagnosis, preventive care, and personalised health guidance.

Dr. Ben Harbi received his medical degree from Sapienza University in Rome. His training included hands-on experience in diverse settings — tropical medicine, rural healthcare, and urban outpatient practice. He also conducted clinical research in microbiology, exploring the role of the gut microbiome in chronic gastrointestinal issues.

You can consult Dr. Ben Harbi for:

  • General health concerns, prevention, and primary care.
  • Hypertension, type 1 and type 2 diabetes, metabolic issues.
  • Cold, cough, flu, respiratory infections, sore throat, fever.
  • Chronic digestive issues: bloating, gastritis, IBS, microbiome imbalance.
  • Skin rashes, mild allergic reactions, basic dermatological complaints.
  • Medication guidance, treatment adjustments, prescription review.
  • Paediatric concerns — fever, infections, general well-being.
  • Lifestyle optimisation: stress, sleep, weight, and diet counselling.

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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Key areas of expertise:

  • Addiction treatment: alcohol and drug dependence, gambling addiction, compulsive behaviours, codependent relationships.
  • Support for families of addicted individuals, behavioural correction within the family system, guidance for maintaining remission.
  • Mental health: depression, bipolar disorder, obsessive-compulsive disorder (OCD), anxiety disorders, phobias, PTSD, generalised anxiety, emotional trauma, and the psychological impact of loss or emigration.
  • Psychoeducation: explaining complex mental health concepts in simple language, helping patients and their families understand diagnoses and treatment steps.
Therapeutic approach:
  • Client-centred, straightforward, and empathetic – focused on practical outcomes and emotional stabilisation.
  • Prescribes medications when needed, but always aims to minimise unnecessary pharmaceutical use.
  • Certified in multiple evidence-based methods: CBT, NLP (Master Practitioner), Ericksonian hypnosis, symbol drama, art therapy, and systemic therapy.
  • Each consultation results in a clear, structured plan – patients leave knowing exactly what to do next.
Experience and background:
  • Member of the German association Gesundheitpraktikerin and the NGO “Mit dem Sonne in jedem Herzen.”
  • More than 18 publications in international peer-reviewed journals, translated into several languages.
  • Volunteer work with Ukrainian refugees and military personnel at the University Clinic of Regensburg.
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  • concern about gut health or long-term digestive issues
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Dr Habrykevych follows evidence-based medical standards and adapts each consultation to the patient’s individual situation. The online format allows for timely medical support without the need for an in-person visit.
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  • Sports-related injuries: prevention, treatment, and recovery planning.
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With a personalised, evidence-based approach, Dr. Nalkin helps patients restore physical function, reduce pain, and improve quality of life through targeted therapy and long-term support.

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  • Chronic pain syndromes – fibromyalgia, neuropathic pain, post-traumatic pain.
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  • Multiple sclerosis – diagnosis, monitoring, long-term support.
  • Dizziness and coordination disorders.
  • Sleep disturbances – insomnia, daytime sleepiness, fragmented sleep.
  • Anxiety, depression, and stress-related conditions.

Dr. Agapova helps patients manage complex neurological symptoms like pain, numbness, weakness, poor sleep, and emotional distress. Her consultations focus on accurate diagnosis, clear explanation of findings, and tailored treatment plans.

If you’re struggling with chronic pain, migraines, nerve disorders, or sleep problems, Dr. Agapova offers professional guidance to restore your well-being.

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  • Digestive issues: heartburn, bloating, constipation, IBS symptoms.
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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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  • Urinary tract infections and other common infections.
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With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
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Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
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  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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