Donepezil is a prescription medication used to treat symptoms of Alzheimer's disease by increasing acetylcholine in the brain.
Key points:
- Mechanism: Cholinesterase inhibitor (reversible inhibitor of acetylcholinesterase) -> more acetylcholine available.
- Indications: Mild, moderate, and severe Alzheimer’s disease (brand name Aricept; also available as Aricept ODT).
- Dosing (adult):
- Start: 5 mg once daily at bedtime.
- If tolerated after 4–6 weeks: increase to 10 mg once daily.
- For moderate to severe AD, after at least 3 months on 10 mg/day and if well tolerated, some patients may be switched to 23 mg once daily at bedtime (for added benefit).
- Do not exceed recommended doses unless advised by a clinician.
- Administration: Can be taken with or without food. ODT form dissolves on the tongue.
- Common side effects: Nausea, vomiting, diarrhea, loss of appetite, weight loss, muscle cramps, fatigue, dizziness, insomnia. Bradycardia and fainting can occur.
- Warnings/cautions:
- Use with caution in people with heart rhythm problems (bradyarrhythmias), ulcers/bleeding risk, asthma or COPD (may increase secretions/bronchospasm), or other conditions affected by increased acetylcholine.
- May interact with other cholinesterase inhibitors and certain anesthesia drugs; can affect gut and airway secretions.
- Interactions to be aware of: Other cholinesterase inhibitors or anticholinergic drugs (opposite effects); certain NSAIDs can raise GI bleeding risk; additives with anesthesia may affect neuromuscular function.
- Pregnancy/Lactation: Limited data; generally considered only if clearly needed. Discuss with your clinician.
- Monitoring: Cognitive function (e.g., MMSE or similar), weight/appetite, GI symptoms, heart rate (for those with heart rhythm issues).
- What it does not do: It does not cure Alzheimer's or halt progression; it may help with symptoms in some people for a period of time.
If you have a specific question (e.g., dosing for a particular situation, side effects you’re experiencing, drug interactions, or comparing with another Alzheimer’s drug), tell me and I’ll tailor the info.