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Nivalin

Ask a doctor about a prescription for Nivalin

5.0(1)
Doctor

Lina Travkina

Family medicine12 years of experience

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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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! The leaflet should be kept. 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 medicine, as it contains important information for the patient.

  • Keep this leaflet, you may need to read it again.
  • In case of any doubts, consult a doctor or pharmacist.
  • This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm them, 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, pharmacist, 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 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 (movement)
  • if the patient has severe kidney or liver failure.

Warnings and precautions

Before starting to use Nivalin, the patient should discuss it with their 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 the heart rate (digoxin, beta-adrenergic receptor blockers);
  • if the patient has high or low potassium levels in the blood;

Page 1 of 4

  • if the patient has symptoms of Parkinson's disease (tremors, stiffness, masked face, slow movements, and shuffling gait);
  • if the patient has severe respiratory disease (obstructive pulmonary disease);
  • if the patient has moderate kidney failure 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

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

Pregnancy and breastfeeding

If the patient is pregnant or breastfeeding, thinks they may be pregnant, or plans to have a child, they should consult their doctor before using this medicine.

Driving and using machines

Nivalin may cause vision disturbances, dizziness, and drowsiness, which may affect the 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 the medicine 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: Nivalin is available in a dose of 2.5 mg/ml and 5 mg/ml.

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. Usually, 40 to 60 days. Treatment cycles can be repeated 2-3 times at intervals of 1-2 months. Page 2 of 4

Use of a higher dose of Nivalin than recommended

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 about the use of the medicine, the patient should consult their doctor.

4. Possible side effects

Like all medicines, Nivalin can cause side effects, although not everybody gets them. Nivalin may slow 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. Weight loss and loss of appetite have been reported. Some patients may experience allergic reactions, including itching, skin rash, hives, and rhinitis. In rare cases, severe hypersensitivity reactions with loss of consciousness have been observed.

Reporting side effects

If any side effects occur, including any side effects not listed in this leaflet, the patient should inform their doctor, pharmacist, 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, more information can be collected on the safety of the medicine.

5. How to store Nivalin

The medicine should be stored out of sight and reach of children. Store in a temperature below 25°C. Do not freeze. Store in the original packaging to protect from light. Do not use this medicine after the expiry date stated on the packaging. The expiry date refers to the last day of the month stated. Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines 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 medicine 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.

Packaging:

Page 3 of 4. Ampoules made of colorless glass, packaged in cardboard inserts, 5 pieces, or in PVC blisters, 10 pieces. 1 blister placed in a cardboard box with a patient leaflet.

Package size:

Nivalin 5 mg/ml, 1 blister of 5 or 10 ampoules in a cardboard box. For more detailed information, the patient should contact the marketing authorization holder or 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:

Delfarma Sp. z o.o., ul. Św. Teresy od Dzieciątka Jezus 111, 91-222 Łódź

Repackaged by:

Delfarma Sp. z o.o., ul. Św. Teresy od Dzieciątka Jezus 111, 91-222 Łódź. Marketing authorization number in Latvia, the country of export: 06-0145

Parallel import authorization number: 360/17 Date of approval of the leaflet: 17.10.2022

[Information about the trademark]
Page 4 of 4

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
Prescription required
Dosage form: solution, 15mg/ml per 1ml
Manufacturer: PrAT "Lekhim - Harkiv
Prescription required
Dosage form: tablets, tablets 20mg
Manufacturer: AT "Olajnfarm
Prescription required
Dosage form: solution, 15mg/ml in 1ml ampoule
Prescription required
Dosage form: solution, 5 mg/ml in 1 ml ampoule
Prescription required
Dosage form: tablets, 20mg
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.

5.0(1)
Doctor

Lina Travkina

Family medicine12 years of experience

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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Cardiology16 years of experience

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Areas of expertise:

  • dyslipidaemia and lipid metabolism disorders
  • prevention and management of atherosclerosis
  • blood pressure monitoring and antihypertensive therapy
  • arrhythmias: diagnosis, follow-up, and treatment adjustment
  • cardiovascular care and recovery support after Covid-19
Dr Kuznetsova helps patients manage cardiovascular risk factors, optimise long-term treatment, and gain clarity in complex health situations – all through accessible and structured online care.
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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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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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You can consult Dr. Bessolitsyna about:

  • Joint pain — acute, chronic, or recurring pain.
  • Inflammatory arthritis: rheumatoid arthritis, psoriatic arthritis, polyarthritis, gouty arthritis.
  • Degenerative joint conditions: osteoarthritis, knee and hip arthritis (gonarthrosis, coxarthrosis), nodal polyosteoarthritis.
  • Periarthritis and spondyloarthritis.
  • Spinal inflammation: ankylosing spondylitis (Bechterew’s disease).
  • Systemic autoimmune diseases: lupus, scleroderma, systemic vasculitis.
  • Osteoporosis and bone fragility.

Dr. Bessolitsyna offers a personalised and structured approach — helping patients identify causes of joint pain, interpret test results, and follow tailored treatment plans. Her consultations focus on early diagnosis, symptom control, complication prevention, and improving long-term quality of life.

With remote access to specialist care, patients can receive expert rheumatology support wherever they are.

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  • Preventive care and vaccination planning, including catch-up schedules for children.
  • Assessment of psychomotor, emotional, and physical development.
  • Diagnosis, treatment planning, and clinical monitoring for paediatric conditions.
  • Nutritional guidance for infants, including the choice of adapted milk formulas tailored to medical needs.
  • Early identification of rare and orphan diseases.
  • Ongoing care for children with chronic or complex health conditions.
By combining paediatrics with a personalised approach, Dr. Savin ensures professional support that addresses both the physical health and overall well-being of children, while guiding parents at every stage of their child’s growth.
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  • Depressive episodes and mood disorders.
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Dr. Tskipurishvili applies evidence-based methods, including cognitive behavioural therapy (CBT), pharmacotherapy, coaching, and MAC therapy techniques. His approach is structured, compassionate, and tailored to each patient’s unique needs.

Focused on restoring emotional stability and improving quality of life, Dr. Tskipurishvili offers professional psychiatric care and personalised treatment plans through online consultations.

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Anna Moret

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Combining dermatology with general medical knowledge, Dr. Moret offers comprehensive care that addresses both skin health and underlying conditions. She also holds certification from the Canadian Board of Aesthetic Medicine, ensuring an internationally aligned approach to aesthetic dermatology.

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  • Ongoing care for patients with osteoporosis, pituitary, and adrenal gland disorders
Dr. Tabeshadze takes a patient-centred approach based on evidence-based medicine. Her goal is to help patients achieve hormonal balance, manage chronic conditions effectively, and improve overall well-being through targeted, personalised care.
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Key areas of expertise:

  • Erectile dysfunction, decreased libido, premature ejaculation.
  • Male infertility: comprehensive diagnosis and modern treatment methods.
  • Prostate gland diseases: acute and chronic prostatitis, prostatic adenoma (benign prostatic hyperplasia), prostate cancer.
  • Inflammatory diseases of the genitourinary system: acute and chronic cystitis, pyelonephritis, epididymitis, orchitis, urethritis.
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Dr. Eremeishvili applies an integrated approach to each case. This includes thorough preoperative preparation, postoperative observation, and regular dynamic follow-up during the treatment process to achieve the best possible outcomes. All diagnostic and therapeutic recommendations are based on current evidence-based medicine and comply with the recommendations of the European Association of Urology, guaranteeing high-quality and effective care.

If you are seeking qualified assistance in diagnosing or treating urological conditions, book an online consultation with Dr. Giorgi Eremeishvili. Get expert support, accurate diagnosis, and a personalized treatment plan from the comfort of your home.

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