Donepezil

Sounds like 'doe-nep-e-zil'

Key points about donepezil

  • Donepezil is used to treat dementia associated with Alzheimer's disease.
  • Donepezil is also called Aricept. 
  • Find out how to take it safely and possible side effects. 
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Donepezil is in a class of medications called cholinesterase inhibitors. It's used to treat mild-to-moderate dementia due to Alzheimer's disease and vascular dementia. Donepezil may also be used for people with mixed dementia, dementia in Parkinson's disease and dementia with Lewy bodies.

Donepezil helps to ease the symptoms of mild to moderate dementia, such as memory loss, but doesn't cure it. Donepezil works by increasing the amount of a chemical in the brain called acetylcholine, known to be lower in people living with dementia due to Alzheimer's disease. Read more about medicines for dementia.

In Aotearoa New Zealand donepezil is available as tablets (5mg and 10mg). 

  • The usual starting dose of donepezil is 5 milligrams (mg) once daily, in the evening.
  • After at least 1 month, your doctor will assess your response and may increase your dose to 10 milligrams daily.
  • Always take your donepezil exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

  • Timing: Take donepezil once a day, in the evening before bedtime. You can take donepezil with or without food.
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Don't take double the dose.
  • Keep taking donepezil every day. Donepezil doesn't work straight away. It usually takes a few weeks before you notice the full benefits. If you forget to take donepezil for more than a few days, talk to your doctor before starting to take it again. You may need to restart donepezil on a lower dose. Read more about tips when taking medicines for dementia.   

Here are some things to know when you're taking donepezil. Other things may be important as well, so ask your healthcare provider what you should know about.

You may need regular tests

Before you start donepezil, you will have an ECG to check your heart. While you're taking donepezil you'll be monitored by your doctor regularly to check your heart rate, and to monitor for any side effects. Your doctor will check your response to treatment, if the dose is right, and if this medicine is right for you.

Taking other medicines and supplements

Donepezil can interact with some medicines, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting donepezil and before starting any new products.

Donepezil may affect your ability to drive

Donepezil can impair your ability to do tasks such as driving or using machines. Alcohol makes this worse. Discuss your risk with your healthcare provider.

Tell your healthcare providers

Make sure you tell anyone providing you with health, dental or medical care that you are taking donepezil. This is particularly important if you're going to need a general anaesthetic.

Like all medicines, donepezil can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine

Side effects What should I do?
  • Nausea (feeling sick) or vomiting
  • Try taking donepezil with food or a snack and make sure you are drinking enough water.
  • Tell your doctor if it bothers you; they may recommend a lower dose.
  • Loss of appetite
  • Headache
  • Diarrhoea (runny poos)
  • These are quite common when you first start taking donepezil and usually go away with time.
  • Your doctor may check your weight at your regular visits.
  • Tell your doctor if they bother you. 
  • Trouble sleeping, strange dreams, hallucinations, agitation
  • Tell your doctor.
  • Muscle cramps, itch, rash
  • Tell your doctor. 
  • Tiredness
  • Dizziness
  • Feeling faint
  • Try getting up or moving slowly – you are at increased risk of falls.
  • If you begin to feel faint, sit or lie down until the feeling passes.
  • Avoid driving until you know how this medicine affects you.
  • Don't drink alcohol.
  • Tell your doctor if this continues.
  • Signs of problems with your heart such as slow or irregular heartbeat – including feeling your heart skips a beat, dizziness or fainting
  • Tell your doctor immediately or ring Healthline 0800 611 116.
  • Signs of stomach problems such as really bad tummy pain, blood in your stool (poo) or black stools, vomiting blood or dark-coloured vomit.
  • Tell your doctor immediately or ring Healthline 0800 611 116.
Did you know that you can report a medicine side effect to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.(external link)

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Joanna Wang, Old Age Psychiatrist; Angela Lambie, Pharmacist, Auckland

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