Donepezil hydrochloride
Donepezil hydrochloride (Aricept)
Donepezil hydrochloride
(dohn- EP-eh-zil)
Pregnancy Category: C Aricept (Rx)

Classification: Psychotherapeutic drug for Alzheimer's disease

Action/Kinetics: A decrease in cholinergic function may be the cause of Alzheimer's disease. Donepezil is a cholinesterase inhibitor and exerts its effect by enhancing cholinergic function by increasing levels of acetylcholine. No evidence that the drug alters the course of the underlying dementing process. Well absorbed from the GI tract. Peak plasma levels: 3-4 hr. Food does not affect the rate or extent of absorption. Metabolized in the liver, and both unchanged drug and metabolites are excreted in the urine and feces.

Uses: Treatment of mild to moderate dementia of the Alzheimer's type.

Contraindications: Hypersensitivity to piperidine derivatives.

Special Concerns: Use with caution in clients with a history of asthma or obstructive pulmonary disease. Safety and efficacy have not been determined for use in children.

Side Effects: NOTE: Side effects with an incidence of 1% or greater are listed. GI: N&V;, diarrhea, anorexia, fecal incontinence, GI bleeding, bloating, epigastric pain. CNS: Insomnia, dizziness, depression, abnormal dreams, somnolence. CV: Hypertension, vasodilation, atrial fibrillation, hot flashes, hypotension, bradycardia. Body as a whole: Headache, pain (in various locations), accident, fatigue, influenza, chest pain, toothache. Musculoskeletal: Muscle cramps, arthritis, bone fracture. Dermatologic: Diaphoresis, urticaria, pruritus. GU: Urinary incontinence, nocturia, frequent urination. Respiratory: Dyspnea, sore throat, bronchitis. Ophthalmic: Cataract, eye irritation, blurred vision. Miscellaneous: Dehydration, syncope, ecchymosis, weight loss.

Overdose Management: S ymptoms: Cholinergic crisis characterized by severe N&V;, salivation, sweating, bradycardia, hypotension, respiratory depression, collapse, convulsions, increased muscle weakness (may cause death if respiratory muscles are involved). Treatment: Atropine sulfate at an initial dose of 1-2 mg IV with subsequent doses based on the response. General supportive measures.

Drug Interactions: Anticholinergic drugs / The cholinesterase inhibitor activitiy of donepezil interferes with the activity of anticholinergics Bethanechol / Synergistic effect Ketoconazole / Peak plasma levels of donepezil R/T breakdown by liver NSAIDs / Gastric acid secretion risk of active or occult GI bleeding Succinylcholine / Muscle relaxant effect

How Supplied: Tablet: 5 mg, 10 mg

Dosage
?Tablets Alzheimer's disease.
Initial: 5 mg. Use of a 10-mg dose did not provide a clinical effect greater than the 5-mg dose; however, in some clients, 10 mg daily may be superior. Do not increase the dose to 10 mg until clients have been on a daily dose of 5 mg for 4 to 6 weeks.