Drug Facts: Aricept (donepezil)

August 3, 2010

Generic name: donepezil

Sold as 5 mg (white) and 10 mg (yellow) round tablets.

Why It’s Prescribed
To ease the symptoms of early Alzheimer’s. Improves, maintains, or slows the decline in thinking skills and overall ability to perform daily activities of living, such as dressing, eating, or handling mail. It may also curb behavior problems such as delusions (imagining things are there when they are not), loss of interest in usual activities, or nighttime wandering. However, it does not halt disease progression long term.

Who Benefits
People with mild to moderate Alzheimer’s disease. In some studies, up to 80 percent of patients with early Alzheimer’s showed some benefits from the drug.

How it Works
Slows the breakdown of acetylcholine, a chemical that aids memory by transmitting messages between brain cells.

Dosage Guidelines
To start: 5 mg at bedtime. Average daily dose: 5 to 10 mg, taken once a day before going to bed. May be taken with or without food.

Onset of Effect
Benefits, if they occur, may be noticed within several weeks of starting the drug.

Store in a tightly sealed container away from heat, moisture and light.

Missed Dose
Skip the missed dose and resume your regular schedule.

Long-term Use
The drug is taken long term and may move the clock back a few months, but the disease continues to progress. If the drug seems to stop working, your doctor may switch you to another Alzheimer’s drug.

Side Effects
Serious: There are no serious side effects. Most common: Nausea, vomiting, diarrhea. These side effects typically subside within one to three weeks. Less common: Headache, dizziness, fatigue, insomnia or unusual dreams, drowsiness, depression, loss of appetite, bleeding or bruising, fainting, muscle cramps, frequent need to urinate, achy, stiff or swollen joints.

Precautions & Special Concerns
If you are having surgery or any dental or emergency procedures that require anesthesia, let your doctor know you are taking the drug. Do not drive until you see how the medicine affects you, since it may cause drowsiness.

When to Call the Doctor
If you experience troublesome side effects or the drug seems to stop working.

In Case of Overdose: Symptoms & What to Do
Seizures, severe nausea or vomiting, slowed heartbeat, weak muscles, profuse sweating, increased salivation, weak pulse, irregular breathing, convulsions. Call your doctor, emergency medical services, or poison control center immediately.

Drug Interactions
May interact with carbamazepine, ketoconazole, phenobarbital, phenytoin, quinidine, dexamethasone, and rifampin. Let your doctor know if you are taking these or any other medications. Antihistamines, antipsychotic drugs, and some drugs for incontinence may also diminish its effects.

Food Interactions
No known food interactions. Avoid alcohol while using this medicine.

Disease Interactions
Consult your doctor if you have asthma, lung disease, urinary tract problems, heart or liver disease, seizures, or an ulcer.

Expert comment
“For some people with Alzheimer’s disease, this drug can lead to improvements that the family can see. In others, responses may only be detectable under special testing conditions, or there may be no measurable response at all. It is important that family members and physicians maintain realistic expectations for drug therapy and remember that, as with all current Alzheimer’s drugs, responses are generally only modest at best.” –Samuel E. Gandy, M.D., Ph.D., Scientific Advisory Board, Fisher Center for Alzheimer’s Research Foundation


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