Donepezil 5mg

Acetylcholinesterase Inhibitor

CSA NA – FDA Approved – REMS (N) – Can Ship

Donepezil/Aricept reversibly and noncompetitively inhibits centrally acting acetylcholinesterase which is the enzyme that breaks down acetylcholine via hydrolysis.  This increases synaptic levels of acetylcholine for central nervous system transmission.  Alzheimer’s disease results in cholinergic deficiencies in the cortex and basal forebrain which results in cognitive deficits, so increasing acetylcholine counters this.

Donepezil/Aricept is officially indicated for Alzheimer disease, but it may also be prescribed off-label for other forms of dementia such as Lewy body, vascular, and Parkinson associated (may also be used for conditions not listed)

Before starting Donepezil/Aricept make sure your physician is aware of any allergies or medications you currently take, if you have peptic ulcer disease, respiratory disease, a seizure disorder, a urinary tract obstruction, are pregnant, or breastfeeding

2.5-20mg once daily

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day, usually at bedtime, without regard to food, store at room temperature    

Diarrhea, nausea, insomnia, accidental injury, bruising, anorexia, weight loss, dizziness, fatigue

Note this is not a complete list of side effects, only common ones.  May cause QT prolongation, so be careful if mixing with other QT prolonging agents to minimize risk of severe arrythmia.  May also rarely cause neuroleptic malignant syndrome. 

1. What is Neuroleptic Malignant Syndrome?
   NMS is a rare but serious reaction from significant blockade of dopamine which can occur from antipsychotic medications or from being on high dosages of levodopa (dopamine analogue) and stopping suddenly.  Presents initially as muscle cramps, tremors, fever, unstable blood pressure, and sudden changes in mental status.  As it progresses over 8-40 hours it can lead to complications of rhabdomyolysis, hyperkalemia, kidney failure, or seizures.  Seek medical attention immediately if this reaction is suspected.
2. No improvement has occurred since starting this medication, should I keep taking it?
   This medication does not improve memory or other symptoms of dementia, it only slows the progression of the condition, so it is important to be continued.  It is important to understand this distinction so expectations can be effectively managed.