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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! 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 Україна

Dosage form: розчин, 5 мг/мл по 1 мл
Manufacturer: PrAT "Lekhim - Harkiv
Prescription required
Dosage form: розчин, 15 мг/мл по 1 мл
Manufacturer: PrAT "Lekhim - Harkiv
Prescription required
Dosage form: таблетки, таблетки по 20 мг
Manufacturer: AT "Olajnfarm
Prescription required
Dosage form: розчин, 15 мг/мл по 1 мл в ампулі
Prescription required
Dosage form: розчин, 5 мг/мл по 1 мл в ампулі
Prescription required
Dosage form: таблетки, по 20 мг
Manufacturer: PAT "Kiivmedpreparat
Prescription required

Alternative to Nivalin in Іспанія

Dosage form: ТАБЛЕТКА, 60 мг
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(12)
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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  • Metabolic syndrome, prediabetes, lipid disorders – risk assessment, lifestyle recommendations, and medical treatment
  • Calcium metabolism disorders – diagnosis and management of osteoporosis, hyperparathyroidism, and hypoparathyroidism
Dr Neshta applies current clinical guidelines and diagnostic tools, offering medical support adapted to each patient’s individual needs — all in an accessible online format.
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  • bloating, excessive gas, nausea or vomiting
  • diarrhoea, constipation, difficulty passing stool
  • unexplained changes in weight or appetite
  • concern about gut health or long-term digestive issues
  • changes in lab results, questions about test interpretation
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  • general digestive check-ups and health assessments
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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  • 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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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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  • Metabolic syndrome, excess weight, high cholesterol.
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  • Respiratory symptoms: colds, flu, sore throat, cough, fever.
  • 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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Thanks to his dual specialization in neurology and psychiatry, Dr Sergey Ilyasov offers integrated and evidence-based care for complex conditions requiring a multidisciplinary approach. His consultations focus on accurate diagnosis, development of an individualized treatment plan (including pharmacotherapy and psychotherapeutic methods), and long-term support adapted to each patient's unique needs.

Book an online consultation with Dr. Sergey Ilyasov to receive qualified assistance and improve your well-being today.

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