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Donepezil

Brands and Forms

  • Aricept
    • tablet: 5mg, 10mg.
    • orally disintegrating tablet: 5mg, 10mg.

Uses of Donepezil

Donepezil is used for treating Dementia. It delays the progression of the cognitive decline, and can also help to control some of the behavioral symptoms associated with Dementia.

How Donepezil Works

Donepezil is a cholinesterase inhibitor. It blocks the actions of centrally-acting acetylcholinesterase (AChE), thus making acetylcholine more available in the central nervous system.

Cautions when Using Donepezil

Use with caution in people with asthma and other respiratory diseases, and seizure disorder.

Dosing of Donepezil

The usual therapeutic range of Donepezil is 5-10mg/day, given once daily at bedtime. It can be started at 5mg/day, and increased to 10mg/day after 4-6 weeks depending on clinical response.

When wanting to stop Donepezil, the dose should be decreased gradually over a period of a couple of weeks.

Onset of action

May take up to 6 weeks before any improvement in memory of behavior becomes evident.

Kidney impairment

Reduce dose in patients with moderate renal function impairment. Do not administer to patients with severe renal function impairment (Ccr less than 30 mL/min).

Liver impairment

Use with caution. May need to lower dose.

Side-effects of Donepezil

Below is a list of most of the reported side-effects of Donepezil. Most of these side-effects occur in only a minority of individuals, and many also resolve with time while the medication is continued.

Cardiovascular: palpitations; vasodilatation; hypertension; peripheral edema; fainting (rare).

Central Nervous System: insomnia; weakness; dizziness; paresthesia; headache; somnolence; decreased libido; amnesia; abnormal thinking; tremor; seizures (rare).

Dermatologic: itchiness; sweating; rash.

Eyes, Ears, Nose and Throat: dry mouth; pharyngitis; abnormal vision; taste perversion.

Gastrointestinal: diarrhea; nausea; loss of appetite; flatulence; vomiting; dyspepsia; worsening of gastric ulcers; constipation; increased appetite.

Genitourinary: impotence.

Muskuloskeletal: muscle pains and weakness.

Psychiatric: anxiety; depression; suicidal tendencies (rare).

Respiratory: rhinitis; increased cough; dyspnea; bronchitis; respiratory depression (rare).

Common side-effects of Donepezil

Diarrhea, insomnia, muscle weakness, anxiety.

Rare but serious side-effects of note of Donepezil

  • Bradycardia and AV-block
  • Seizures

Donepezil overdose

Nausea, vomiting, excess salivation, sweating, hypotension, bradycardia, cardiovascular collapse, convulsions, muscle weakness including weakness of respiratory muscles. Can be fatal.

Donepezil and pregnancy

Category C: some animal studies show adverse effects at very high doses, but no controlled human studies have been done. It is unlikely that Donepezil would be used for women of childbearing age.

Medical Monitoring for Donepezil

None for healthy individuals

Drug Interactions with Donepezil

  • Donepezil blood levels may be increased by Amitriptyline, Fluoxetine, Fluvoxamine, and Quinidine.
  • Bradycardia could occur if combined with beta-blockers.
  • Donepezil can work synergistically with Bethanechol and Succinylcholine.