Generic Name: donepezil (oral) (doe NEP e zil)Brand Names: Aricept, Aricept ODT
Donepezil improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine (ah see til KO leen). People with dementia usually have lower levels of this chemical, which is important for the processes of memory, thinking, and reasoning.
Donepezil is used to treat mild to moderate dementia caused by Alzheimer's disease.
Donepezil may also be used for other purposes not listed in this medication guide.
Before taking donepezil, tell your doctor if you have a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats), an enlarged prostate, urination problems, asthma, obstructive pulmonary disease, or a seizure disorder such as epilepsy.
If you need to have any type of surgery, tell the surgeon ahead of time that you are taking donepezil.Donepezil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Before taking donepezil, tell your doctor if you are allergic to any drugs, or if you have:
a heart rhythm disorder such as "sick sinus syndrome" (slow heartbeats);
a history of stomach ulcers;
an enlarged prostate or urination problems;
epilepsy or other seizure disorder; or
asthma or chronic obstructive pulmonary disease (COPD).
If you have any of these conditions, you may need a dose adjustment or special tests to safely take donepezil.FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether donepezil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
If you need to have any type of surgery, tell the surgeon ahead of time that you are taking donepezil. You may need to stop using the medicine for a short time.
Donepezil can be taken with or without food or milk.Take the donepezil regular tablets with a full glass of water.
To take donepezil orally disintegrating tablet (Aricept ODT):
Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel or cut the backing from the tablet blister. Do not push a tablet through the backing or you may damage the tablet.
Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.
Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
Swallow several times as the tablet dissolves. After the tablet dissolves completely, drink a glass of water.
See also: Donepezil dosage in more detail
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
Overdose symptoms may include severe nausea, vomiting, drooling, sweating, blurred vision, feeling light-headed, slow heartbeat, shallow breathing, muscle weakness, fainting, or seizure (convulsions).
black, bloody, or tarry stools;
coughing up blood or vomit that looks like blood or coffee grounds;
painful or difficult urination;
seizure (black-out or convulsions);
Less serious side effects may include:
nausea, vomiting, diarrhea;
loss of appetite;
tired feeling; or
sleep problems (insomnia).
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Alzheimer's Disease:
Initial dose: 5 mg orally once a dayThe dosages of donepezil shown to be effective in controlled clinical trials of the treatment of mild to moderate Alzheimer's disease are 5 mg or 10 mg administered once per day. The higher dose of 10 mg did not provide a statistically significantly greater clinical benefit than 5 mg. However, there has been some evidence to suggest that a daily dose of 10 mg of donepezil might provide additional benefit for some patients. Accordingly, whether or not to use a dose of 10 mg is a matter of prescriber and patient preference.Donepezil has been shown to be effective in controlled clinical trials of the treatment of severe Alzheimer's disease at a dose of 10 mg administered once daily. Evidence from the controlled trials in mild to moderate Alzheimer's disease has indicated that the 10 mg dose, with a one week titration, is likely to be associated with a higher incidence of cholinergic adverse events than the 5 mg dose. In open label trials using a 6-week titration, the frequency of these same adverse events was similar between the 5 mg and 10 mg dose groups. Because steady state is not achieved for 15 days and because the incidence of side effects may be influenced by the rate of dose escalation, a dose of 10 mg should not be achieved until patients have been on a daily dose of 5 mg for 4 to 6 weeks.Donepezil should be taken in the evening, just prior to retiring. Donepezil can be taken with or without food.The orally disintegrating tablet (marketed as Aricept ODT) should be allowed to dissolve on the tongue and then be followed with water.
Before taking donepezil, tell your doctor if you are taking any of the following medicines:
atropine (Donnatal, and others);
hyoscyamine (Anaspaz, Cystospaz, Levsin, and others);
methscopolamine (Pamine), scopolamine (Transderm-Scop);
phenobarbital (Luminal, Solfoton);
quinidine (Cardioquin, Quinidex, Quinaglute, others);
rifampin (Rifadin, Rifamate, Rifater);
a fungal antibiotic such as ketoconazole (Nizoral), fluconazole (Diflucan), or itraconazole (Sporanox); or
aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), piroxicam (Feldene), and others.
This list is not complete and there may be other drugs that can interact with donepezil. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.