Aricept (Donepezil)
What is Aricept
Aricept, known generically as Donepezil, is a medication used to treat symptoms of Alzheimer’s disease and other types of dementia. It belongs to a class of drugs called cholinesterase inhibitors, which work by increasing the levels of a brain chemical called acetylcholine. This chemical is important for memory, thought, and reasoning, and is often found at lower levels in individuals with dementia.
Aricept doesn’t cure Alzheimer’s disease, but it can help improve or maintain memory, awareness, and the ability to perform daily functions for a period of time. It is usually prescribed in tablet form (5 mg, 10 mg, or 23 mg) and taken once daily, often in the evening before bedtime.
Recommendations
Aricept is primarily prescribed for:
• Mild, moderate, and severe Alzheimer’s disease;
• Other dementias, in certain cases, as determined by the healthcare provider.
The typical starting dose is 5 mg once daily, which may be increased to 10 mg once daily after several weeks. In patients with more advanced disease, higher doses such as 23 mg may be considered. The decision depends on tolerance and the patient’s response to treatment.
Aricept is most effective when taken consistently and as part of a broader care plan that may include therapy, structured activities, and caregiver support.
Precautions and Contraindications
Aricept may not be appropriate for everyone. It should not be used or requires caution in patients with:
• Allergies to donepezil or other cholinesterase inhibitors;
• Heart conditions, such as slow heartbeat or sick sinus syndrome;
• Asthma or chronic obstructive pulmonary disease (COPD), as it may worsen breathing problems;
• Seizure disorders, due to possible increased risk of convulsions;
• Stomach ulcers or gastrointestinal bleeding;
• Liver problems.
Patients and caregivers should inform the doctor about all underlying health conditions before starting Aricept.
Interactions
Aricept can interact with many other medications, so caution is needed. Notable interactions include the following drugs:
• Anticholinergic drugs (e.g., oxybutynin, tolterodine) that may reduce effectiveness;
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin are associated with an increased risk of stomach bleeding;
• Heart rhythm medications (amiodarone, quinidine) may increase risk of irregular heartbeat;
• Antifungal drugs (ketoconazole, itraconazole) can increase donepezil levels;
• Certain antibiotics (erythromycin, clarithromycin) may raise blood concentrations;
• Seizure medications (phenytoin, carbamazepine) can lower donepezil effectiveness.
Always provide a full list of medications and supplements to your healthcare provider before starting treatment.
Side Effects
Like all medications, Aricept can cause side effects, ranging from mild to more severe.
Among the common side effects are the following:
• Nausea and vomiting;
• Diarrhea;
• Loss of appetite and weight loss;
• Insomnia or vivid dreams;
• Muscle cramps;
• Fatigue.
Less common but serious side effects are:
• Slow or irregular heartbeat;
• Fainting or dizziness;
• Severe stomach pain or black/tarry stools (possible bleeding);
• Seizures;
• Severe allergic reactions (rash, swelling, difficulty breathing).
If serious symptoms develop, medical help should be sought immediately.
Overdose
An overdose of Aricept can be life-threatening. Symptoms may include:
• Severe nausea, vomiting, or diarrhea;
• Excessive sweating;
• Very slow heart rate;
• Muscle weakness;
• Seizures;
• Breathing difficulties.
In case of overdose, emergency medical help is required. Treatment usually involves supportive care, monitoring vital signs, and in some cases, administration of atropine to counteract the effects.