donepezil

Generic Name: donepezil (oral) (doe NEP e zil)Brand Names: Aricept, Aricept ODT

What is donepezil?

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.

What is the most important information I should know about donepezil?

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.

What should I discuss with my healthcare provider before taking donepezil?

Do not take this medication if you are allergic to donepezil.

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.

How should I take donepezil?

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.

Donepezil is usually taken at bedtime. Follow your doctor's instructions. Store donepezil at room temperature away from moisture and heat.

See also: Donepezil dosage in more detail

What happens if I miss a dose?

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.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include severe nausea, vomiting, drooling, sweating, blurred vision, feeling light-headed, slow heartbeat, shallow breathing, muscle weakness, fainting, or seizure (convulsions).

What should I avoid while 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.

Donepezil side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using donepezil and call your doctor at once if you have any of these serious side effects:

• 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;

• muscle cramps;

• 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.

Donepezil Dosing Information

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.

What other drugs will affect donepezil?

Before taking donepezil, tell your doctor if you are taking any of the following medicines:

• atropine (Donnatal, and others);

• belladonna;

• carbamazepine (Tegretol);

• clidinium (Quarzan);

• dexamethasone (Decadron);

• dicyclomine (Bentyl);

• glycopyrrolate (Robinul);

• hyoscyamine (Anaspaz, Cystospaz, Levsin, and others);

• mepenzolate (Cantil);

• methantheline (Provocholine);

• methscopolamine (Pamine), scopolamine (Transderm-Scop);

• phenobarbital (Luminal, Solfoton);

• phenytoin (Dilantin);

• propantheline (Pro-Banthine);

• 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.

Where can I get more information?

• Your pharmacist can provide more information about donepezil.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.06. Revision Date: 4/12/2009 4:42:36 PM.