Alzheimer’s disease has long been a space with few disease-modifying options and many symptomatic treatments. That landscape is shifting especially for families navigating cognitive decline and broader dementia-related care.
Related condition guide: Dementia
By 2025:
- Donanemab (Kisunla™) was approved by the FDA (July 2024) for early symptomatic Alzheimer’s disease in patients with confirmed amyloid plaques.
- Lecanemab (Leqembi), initially available only as an IV infusion, gained an FDA-approved subcutaneous maintenance formulation (Leqembi IQLIK) allowing at-home weekly injections after 18 months of IV treatment.
For families and caregivers, this brings both hope and new questions:
- Who qualifies for these drugs?
- How much do they help?
- What are the risks?
- And what does at-home injection really mean in practice?
For step-by-step caregiver guidance and support resources, explore: Help Hub
A New Class of Treatments Anti-Amyloid Antibodies
Both donanemab and lecanemab are monoclonal antibodies that target amyloid-β plaques in the brain:
- They are intended for early symptomatic stages: mild cognitive impairment (MCI) or mild dementia due to Alzheimer’s, with confirmed amyloid pathology.
- They are not for advanced dementia.
- They aim to slow cognitive decline, not restore lost function.
Clinical trials have shown:
- modest slowing of decline (people still worsen over time, just more slowly)
- meaningful benefit for some individuals
- a non-trivial risk of side effects, especially amyloid-related imaging abnormalities (ARIA) such as brain swelling or small bleeds
For broader education on dementia stages and expectations: Dementia
Donanemab (Kisunla™) Key Points
- Approved July 2024 for early symptomatic Alzheimer’s with confirmed amyloid plaques.
- Given as IV infusions at defined intervals.
- Treatment decisions weigh modest cognitive benefits against ARIA risk and the demands of frequent monitoring.
Leqembi IQLIK At-Home Injection After 18 Months of IV Therapy
Originally, lecanemab was available only as IV infusions every two weeks, requiring repeated trips to infusion centers.
In August 2025:
The FDA approved Leqembi IQLIK, a subcutaneous formulation that allows weekly at-home injections by the patient or a caregiver after completing at least 18 months of IV therapy.
Potential benefits:
- reduces the burden of infusion visits
- may improve adherence by making maintenance more convenient
- frees up infusion center capacity
But it also requires:
- reliable caregivers or patients who can safely administer injections
- continued monitoring for ARIA (through MRI and clinical follow-up)
- detailed education on injection technique and side effects
Caregiver resources and practical checklists: Help Hub
What These Therapies Mean for Families
These drugs do not cure Alzheimer’s. They:
- may slow worsening, particularly early on
- require sustained commitment to treatment and monitoring
- carry cost, logistical, and emotional burdens
Families must consider:
- is the person still in a stage where slowing progression could meaningfully preserve function?
- can we realistically manage MRIs, appointments, and injections?
- how does the person with Alzheimer’s feel about the risks, burden, and hoped-for benefits?
For guidance across dementia caregiving decisions: Dementia | Help Hub
Symptom Management Still Matters
Even as disease-modifying treatments emerge, symptomatic care remains central:
- medications for mood, sleep, or agitation
- management of cardiovascular risk factors (hypertension, diabetes, AFib)
- support for swallowing issues and GI problems
- careful review of medications that may worsen cognition (anticholinergics, certain sedatives)
Mood symptoms can overlap with or worsen dementia care stress especially depressive symptoms in patients or caregivers.
Related: Depression
Here, personalization and compounding can have a role:
- creating liquid or easy-to-swallow forms for patients who struggle with pills
- simplifying complex regimens for older adults with multiple conditions
- adjusting formulations to reduce excipients that can cause side effects or interactions
These decisions should always be led by the patient’s clinician, with pharmacy support.
Coordinating Care Neurology, Primary Care, Pharmacy, and Caregivers
Managing Alzheimer’s in 2025 often means:
- neurologists guiding disease-modifying therapy
- primary care handling blood pressure, diabetes, and general health
- caregivers managing day-to-day medication administration
- pharmacies ensuring safe formulations and labeling
AllMedRx’s role:
- to support medication customization when swallowing, tolerability, or polypharmacy challenges arise
- to coordinate with prescribers on safe dosing and documentation
- and to remain transparent and conservative in a rapidly changing landscape
More caregiver support tools: Help Hub
Practical Questions to Ask the Care Team
- “Is my loved one a candidate for donanemab or lecanemab? Why or why not?”
- “What kind of monitoring (MRI, labs) will they need and how often?”
- “If we transition to at-home injections, what does training look like?”
- “How do we manage all the other medications for blood pressure, mood, sleep, or other conditions?”
- “Could any of those medications be simplified or customized to fit their abilities?”
Caregiver-ready resources and planning: Help Hub
Final Thoughts Hope, Boundaries, and Realistic Support
In 2025, Alzheimer’s treatment is no longer a story of “nothing can be done.” But it’s also not a story of miracle cures.
Families face:
- more choices
- more complexity
- more need for clear, compassionate, and practical guidance
AllMedRx cannot decide on these therapies, but we can:
- help adjust the supporting medication environment to be safer and more manageable
- work with clinicians to tailor formulations when needed
- provide clear communication to caregivers navigating an already heavy load
For clinicians and caregivers with questions about personalized medication support in dementia, you can contact us at:
intake@allmedrx.org