Galantamine is a cholinesterase inhibitor with a dual mechanism of action. It is a reversible inhibitor of acetylcholine esterase and enhances the intrinsic action of acetylcholine on nicotinic receptors, leading to increased cholinergic neurotransmission in the CNS. Galantamine has a large volume clearance, low plasma protein binding and a high bioavailability. Short-term, double-blind, placebo-controlled studies have shown that treatment with galantamine produces small improvements on cognitive tests and global measures of change in selected patients with mild to moderately severe Alzheimer's disease. A dose of 16-24 mg/day appears to be the most efficacious, and is the licensed maintenance dose range in most territories. The magnitude of the treatment effect is similar to that of other cholinesterase inhibitors. Adverse events experienced by patients treated with galantamine are usually mild, gastrointestinal and may improve with dose reduction.