Other Brands/Names

Aldomer, Aricept, Alzim, Aricept Evess, Donacept, Dozil dan Fordesia.

How It Works

Donepezil acts by inhibiting acetylcholinesterase activity within the central nervous system (brain). This enzyme breaks down acetylcholine, a chemical messenger required for transmitting signals between nerves. In Alzheimer’s disease, acetylcholine levels are reduced, disrupting some nerve cells that depend on acetylcholine. Without treatment, symptoms gradually worsen over time.

This medicine is intended to protect acetylcholine from being broken down by acetylcholinesterase, thereby raising acetylcholine levels in the central nervous system.

Indications

This medicine is used to treat mild, moderate, and severe Alzheimer’s disease. Although Alzheimer’s disease cannot be cured and will continue to progress, donepezil can improve cognition, memory, decision-making, and language abilities in patients.

Contraindication

Donepezil should not be administered to patients with a history of severe allergy or hypersensitivity to this medicine. Conditions that require special caution while taking donepezil include:

• Cardiac rhythm disorders.

• Risk factors for peptic ulcer disease (stomach ulcers).

• History of asthma or chronic obstructive pulmonary disease (COPD).

• History of seizures.

• History of prostate enlargement.

• Pregnancy or breastfeeding.

Side Effects

Potential side effects of donepezil include:

• Nausea and vomiting.

• Diarrhea.

• Decreased appetite.

• Dizziness.

• Muscle pain or cramps.

• Sleep problems.

• Weakness.

• Headache.

These effects should lessen and resolve within 1–3 weeks. If they continue, consult your doctor. Seek medical help immediately if you develop a slow heartbeat with chest pain, shortness of breath, lightheadedness, or reduced consciousness.

Types

This medicine is available as 5 mg and 10 mg tablets.

Dosage

The dosage of donepezil may be differentiated for adult and elderly patients with dementia due to Alzheimer’s disease, as follows:

• Adults

  • Initial dose: 5 mg once daily just before bedtime.

  • After 1 month, the dose may be increased to 10 mg once daily, with a maximum of 10 mg per day.

• Elderly

  • Start with 5 mg per day taken before bedtime.

  • If needed, increase to 10 mg after 4–6 weeks from the first dose.

Safety

Donepezil is an FDA Category C drug for pregnant mothers. Animal studies have shown adverse fetal effects, while adequate human data are lacking. Use only when the expected benefits are judged to outweigh the potential risks. Consult your doctor before using this medicine if you are pregnant or breastfeeding.

Drug Interactions

The following are potential effects of donepezil interactions with other medicines:

• Increased blood levels of donepezil when it is used with:

  • The antifungal ketoconazole.

  • The antibiotic erythromycin.

  • The antidepressant fluoxetine.

  • The antiarrhythmic quinidine.

• Decreased blood levels of donepezil when it is used with:

  • The antituberculosis agent rifampin.

  • The anticonvulsant phenytoin.

• Interactions with antipsychotic medicines may raise the risk of neuroleptic malignant syndrome, a life-threatening reaction to antipsychotics. Symptoms include:

  • High fever

  • Muscle rigidity

  • Excessive sweating

  • Mental status changes

  • Anxiety

  • Abnormal heartbeat

  • Rapid breathing

• Reduced effectiveness of donepezil when it is used with anticholinergic medicines (which act on the nervous system).

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