Donepezil

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Aricept, Arimentia, Donecept, Donerin

Drug group:

Drug for dementia

Prescription needed?

Yes

What does it do?

Donepezil is useful in the treatment of Alzheimer’s disease:

• Improves the symptoms of dementia in this disease
• Used to diminish deterioration of this condition

Donepezil is NOT currently recommended for dementia due to other causes.

How does it work?

• Donepezil inhibits acetylcholinesterase, an enzyme which breaks down the natural neurotransmitter acetylcholine
• Blocking the enzyme raises acetylcholine levels in the brain, which increases awareness and memory

How should it be used?

Treatment with donepezil is initiated under specialist supervision.

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

Adults 5–10mg, once daily at bedtime

How quickly will it start to work?

Some effect within 1 hour, full effect in up to 3 months.
                                  

How long will the effects last?

1–2 days
                   

When should I stop using it?

Do not stop taking the drug without consulting your doctor. 
               

Is it safe for prolonged use?

No problems expected but there should be six monthly assessments to decide whether the drug is beneficial or not. There will be a gradual loss of the improvements over several weeks after stopping the drug.

What are the possible side effects?

The following have been reported:

• More common: nausea, vomiting, diarrhoea, fatigue, insomnia, muscle cramps, headache
• Less common: agitation, aggression, bladder outflow obstruction (causing urinary incontinence or difficulty in passing urine)
• Report to your doctor before taking your next dose if you experience: fainting, dizziness, palpitations, seizures, urinary problems

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: liver/kidney/heart problems,  asthma or respiratory problems, gastric or duodenal ulcers
• Other medicines: Muscle relaxants, fluoxetine, erythromycin, ketoconazole
• Pregnancy and breast-feeding: Not recommended, safety not established
• Children: Not recommended
• Over 60: No special problems
• Driving and hazardous work: Your underlying condition may make these dangerous
• Alcohol: Avoid, alcohol may reduce the effect of donepezil
• Surgery and general anaesthetics: Donepezil may need to be stopped before you have a general anaesthetic, discuss this with your doctor or dentist