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Nivalin

Ask a doctor about a prescription for Nivalin

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Doctor

Nuno Tavares Lopes

Family medicine17 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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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

LEAFLET INCLUDED IN THE PACKAGING: INFORMATION FOR THE PATIENT

Warning! Keep the leaflet, the information on the immediate packaging is in a foreign language!

Nivalin, 5 mg/ml, solution for injection

Galantamini hydrobromidum

You should carefully read the contents of the leaflet before using the medicine, as it contains important information for the patient.

  • You should keep this leaflet, so that you can read it again if necessary.
  • In case of any doubts, you should consult a doctor or pharmacist.
  • This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
  • If the patient experiences any side effects, including any side effects not listed in this leaflet, they should inform their 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 packaging 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 medicines 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 the patient is allergic to the active substance or any of the other ingredients of this medicine (listed in section 6)
  • if the patient has asthma (breathing difficulties)
  • if the patient has a slow heart rate (bradycardia) or conduction disorders (atrioventricular block)
  • if the patient has coronary heart disease (insufficient blood supply to the heart muscle) or severe heart failure (impaired heart function)
  • if the patient has epilepsy
  • if the patient has excessive motor activity
  • if the patient has severe renal or hepatic impairment.

Warnings and precautions

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

  • if the patient has sick sinus syndrome (disrupted formation of electrical impulses in the heart), prolonged QTc interval or other conduction disorders in the heart;
  • if the patient is taking other medicines that may slow down the heart rate (digoxin, beta-adrenergic receptor blockers);
  • if the patient has high or low potassium levels in the blood;
  • if the patient has symptoms of Parkinson's disease (tremors, stiffness, mask-like face, slow movements and shuffling gait);
  • if the patient suffers from severe respiratory disease (obstructive pulmonary disease);
  • if the patient has moderate renal impairment or urinary tract obstruction, if the patient has recently undergone surgical treatment of the prostate or bladder, as well as during surgical operations under general anesthesia. If the patient loses too much weight during treatment with Nivalin, it should be monitored.

Nivalin and other medicines

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

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, you should consult your doctor before using this medicine.

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

3. How to use Nivalin

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 medicine 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, it is 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 medicine 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 medicine, you should consult a doctor.

4. Possible side effects

Like all medicines, Nivalin can cause side effects, although not everybody gets them. Nivalin may slow down the 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 any side effects not listed in this leaflet, you should 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 gather more information on the safety of the medicine.

5. How to store Nivalin

The medicine should be stored out of sight and reach of children. Do not use this medicine after the expiry date stated on the packaging. The expiry date refers to the last day of the specified month. Store in the original packaging to protect from light. Store at a temperature below 25°C. Do not freeze. Medicines should not be disposed of via wastewater or household waste. You should ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the packaging and other information

What Nivalin contains

  • The active substance of the medicine is galantamine hydrobromide (Galantamini hydrobromidum)
  • The other ingredients are: sodium chloride and water for injections

What Nivalin looks like and what the packaging contains

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

Packaging:

Ampoules made of colorless glass (I hydrolytic class) in a PVC blister pack in a cardboard box.

Package size:

Nivalin, 5 mg/ml, 10 ampoules of 1 ml. For 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:

Medezin Sp. z o.o.
ul. Zbąszyńska 3
91-342 Łódź

Repackaged by:

Medezin Sp. z o.o.
ul. Zbąszyńska 3
91-342 Łódź
CEFEA Sp. z o.o. Sp. komandytowa
ul. Działkowa 56
02-234 Warszawa
Pharma Innovations Sp. z o.o.
ul. Jagiellońska 76
03-301 Warszawa
Synoptis Industrial Sp. z o.o.
ul. Szosa Bydgoska 58
87-100 Toruń
CANPOLAND SPÓŁKA AKCYJNA
ul. Beskidzka 190
91-610 Łódź
Marketing authorization number in Latvia, the country of export: 06-0145
Parallel import authorization number: 48/22
Date of approval of the leaflet: 19.01.2022
[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

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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.

5.0(46)
Doctor

Nuno Tavares Lopes

Family medicine17 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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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
  • Ongoing care for chronic conditions and medication review
  • 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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Tetiana Fedoryshyn

General medicine29 years of experience

Dr Tetiana Fedoryshyn is a senior general practitioner, certified nutritionist, and psychologist with over 29 years of clinical experience. She combines classical internal medicine with modern approaches in lifestyle medicine, functional nutrition, and emotional health support.

Her focus is on helping patients regain health through deep understanding of symptoms, personalised nutrition plans, and evidence-based correction of deficiencies, stress-related conditions, and metabolic imbalances. Dr Fedoryshyn works with adults experiencing chronic conditions, fatigue, hormonal disruption, and post-stress exhaustion.

She integrates medical analysis, psychological insight, and real-life behaviour change tools to offer treatment plans tailored to each patient’s biochemistry, mental state, and lifestyle.

Main areas of practice:

  • Chronic condition management and medical counselling
  • Weight loss programmes based on metabolic profiling
  • Diagnosis and treatment of micronutrient deficiencies
  • Recovery from stress, burnout, and hormonal imbalances
  • Emotional support and psychosomatic symptom care
Her approach is never one-size-fits-all – each consultation begins with a deep dive into your unique health history, test results, and emotional landscape. Consultations are available in Ukrainian, Polish, and Russian.
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Sergei Nalkin

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Dr. Nalkin offers consultations and treatment for:

  • Neurological disorders including migraines, tension headaches, and peripheral neuropathies.
  • Rehabilitation after stroke, brain injury, and spinal cord trauma.
  • Chronic pain syndromes and musculoskeletal dysfunctions.
  • Sports-related injuries: prevention, treatment, and recovery planning.
  • Coordination and movement disorders affecting mobility and balance.
  • Custom rehabilitation programmes for neurological and orthopedic conditions.

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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Liudmyla Boichuk

Family medicine10 years of experience

Dr Liudmyla Boichuk is a family medicine doctor providing diagnosis and treatment for a wide range of acute and chronic conditions in adults and children. She works with respiratory, cardiovascular and digestive system disorders and has extensive experience caring for patients with multiple coexisting conditions, where coordinated, whole-person management is essential.

She treats adults with respiratory illnesses such as pneumonia, COPD and bronchial asthma, as well as cardiovascular conditions including hypertension and ischaemic heart disease. Her practice also covers gastrointestinal complaints and chronic comorbidities that require careful, structured medical supervision.

Dr Boichuk provides care for children from birth, including acute respiratory viral infections, infectious diseases, pneumonia, bronchitis, bronchial obstruction syndromes and allergic reactions. She offers clear, evidence-based guidance to parents and ensures safe follow-up throughout the child’s recovery.

Her work also includes developing personalised immunisation plans and supporting families with long-term preventive care.

Known for her structured clinical approach and clear communication, Dr Liudmyla Boichuk offers patients of all ages comprehensive, reliable and evidence-based medical care.

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Anna Biriukova

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Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • 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.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
  • Metabolic syndrome – obesity, lipid disorders, insulin resistance.
Gastroenterology – Digestive health:
  • Abdominal pain, nausea, heartburn, gastroesophageal reflux (GERD).
  • Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
  • Respiratory infections – cough, colds, bronchitis.
  • Lab test analysis, therapy adjustments, medication management.
  • Adult vaccinations – planning, contraindications assessment.
  • Cancer prevention – screening strategies and risk assessment.
  • Holistic approach – symptom relief, complication prevention, and quality of life improvement.
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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Karim BenHarbi

General medicine8 years of experience

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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Eteri Tabeshadze

Cardiology32 years of experience

Dr. Eteri Tabeshadze is a cardiologist with the highest qualification category and over 32 years of clinical experience. She also practises functional diagnostics, offering a comprehensive approach to cardiovascular care. Dr. Tabeshadze provides online consultations for adults with a wide range of heart-related conditions, from preventive screenings to acute and chronic disease management.

Areas of expertise include:

  • Diagnosis and treatment of hypertension, coronary artery disease, and chronic heart failure
  • Management of arrhythmias and conduction disorders, including paroxysmal events
  • Emergency care: myocardial infarction, acute left ventricular failure, acute pulmonary heart disease
  • Post-thromboembolism care and evaluation of cardiomyopathies
  • Treatment of vegetative dysfunction and autonomic disorders
  • Interpretation of cardiovascular tests: ECG, Holter monitoring, ambulatory blood pressure monitoring (ABPM), echocardiography (including transesophageal echo), stress echocardiography, exercise testing (VEM, treadmill test)
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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Oleksandr Babushkin

Orthopedics and traumatology17 years of experience

Dr Oleksandr Babushkin is an orthopaedic and trauma specialist providing online consultations for adults with joint, muscle, and spine-related concerns. He helps patients accurately assess symptoms, manage chronic and acute musculoskeletal conditions, and build effective recovery strategies through evidence-based care.

Online consultations include:

  • Evaluation of musculoskeletal symptoms: acute or chronic pain, stiffness, and reduced mobility.
  • Diagnosis and treatment advice for joint pain (knees, hips, shoulders, elbows), back and neck pain.
  • Support for conditions such as osteoarthritis, bursitis, tendinitis, and nerve compression syndromes.
  • Guidance after injuries: strains, sprains, bruises, suspected fractures, and overuse injuries.
  • Recovery support following orthopaedic surgery or trauma.
  • Monitoring treatment progress and adjusting therapy based on your symptoms and test results.

You can book a consultation if you experience:

  • Joint pain, limited mobility, or cracking sounds during movement.
  • Back or neck pain, especially with prolonged sitting or physical activity.
  • Chronic discomfort that affects your daily life or sleep.
  • Need for post-surgical follow-up or rehabilitation planning.

Dr Babushkin combines his expertise in orthopaedics and trauma care with a personalised, structured approach — helping patients regain mobility, reduce pain, and improve quality of life.

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