OBJECTIVE: To demonstrate the safety and tolerability of galantamine SA in dementia patients transitioned from donepezil. DESIGN: One group, pretest-posttest SETTING: Veterans Affairs (VA) hospital serving U.S. veterans. PATIENTS, PARTICIPANTS: Charts of 193 patients changed from donepezil to galantamine SA were reviewed. INTERVENTION: In an effort to limit the cost of medications being used for Alzheimer's disease, the Bedford VA Hospital began an initiative to transition patients to the generic sustained-release galantamine SA. A chart review was performed using the VA computerized patient record for all patients transitioned from either donepezil or rivastigmine to galantamine. Progress notes were reviewed for the first three months following initial medication exchange to determine galantamine tolerability and reasons for discontinuation. MAIN OUTCOME MEASURE: Galantamine SA tolerability at three months. RESULTS: Of the 193 patients transitioned to galantamine SA, 94.3% remained on the drug at three months. The most common reason for medication withdrawal was mental status change (n = 5). CONCLUSION: Transition to galantamine SA in a real world clinical setting was well-tolerated among patients with dementia.