Uses
What is donepezil used for?
Donepezil is commonly used to treat mild, moderate, and severe dementia related to Alzheimer’s disease.
Donepezil may also be used for other conditions as determined by your healthcare provider.
How does donepezil work (mechanism of action)?
People with Alzheimer’s disease typically have a decrease in the amount of acetylcholine in their brain. Acetylcholine is a natural chemical in the brain that helps carry messages between brain cells. When there is less acetylcholine, it leads to problems in memory and thinking. Donepezil may help manage symptoms of Alzheimer’s disease by preventing the breakdown of acetylcholine, allowing more acetylcholine to build up in the brain. This can help slow down the worsening of Alzheimer’s disease.
How is donepezil supplied (dosage forms)?
Donepezil is available as Adlarity, Aricept, and generic donepezil in the following dosage forms that are taken by mouth or applied to the skin.
- 5 mg/day, 10 mg/day transdermal patches
- 5 mg, 10 mg, 23 mg oral tablets
- 5 mg, 10 mg orally disintegrating tablets
How should I store donepezil?
Transdermal Patch. Donepezil transdermal patches should be stored in a refrigerator, between 36 F to 46 F (2 C to 8 C). Do not freeze. Remove the pouch from the refrigerator and allow it to reach room temperature before opening it. Keep the patch in the individually sealed pouch until you are ready to apply it. Used patches should be folded with the adhesive surfaces pressed together and discarded in the trash. Do not flush used patches down the toilet.
Oral Tablet and Orally Disintegrating Tablet. Donepezil oral tablets and orally disintegrating tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of donepezil?
The most common side effects of donepezil are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Nausea
- Diarrhea
- Trouble sleeping
- Vomiting
- Muscle cramps
- Tiredness
- Loss of appetite
There may be other side effects of donepezil that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of donepezil?
While less common, the most serious side effects of donepezil are described below, along with what to do if they happen.
Severe Allergic Reactions. Donepezil may cause allergic reactions, which can be serious. Stop using donepezil and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Heart Rhythm Changes. Donepezil may cause heart rhythm problems that can lead to an irregular heartbeat and fainting. In rare cases, this may cause the heart to suddenly stop beating (cardiac arrest). Some people have a higher risk of this, including people with existing heart disease or who take other medicines that affect the heart. Get emergency help if you experience any of the following signs of heart rhythm changes.
- Chest pain
- Shortness of breath
- Feeling dizzy, lightheaded, or fainting
- Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
Stomach Bleeding. Donepezil can increase your risk of bleeding, ulcers, and tears (perforation) in your gut. The risk is higher if you have a history of stomach ulcers, bleeding problems, or take certain other medicines. Stop taking donepezil and get emergency help right away if you have any of the following symptoms.
- Vomit blood
- Black or tarry poop
- Stomach pain that does not go away
- Upset stomach
- Feel faint
Seizures. Some people who have taken donepezil have reported having seizures. There are many different types of seizures and some of them are not easy to recognize. Stop taking donepezil and call your healthcare provider if you experience any of the following signs that a seizure is happening or could happen.
- Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
- Stiffening of your arms and legs
- Feeling anxious, nervous, confused, or a sense of dread
- Feeling dizzy or lightheaded
- Falling or losing consciousness
Inability to Empty Bladder (Urinary Retention). Donepezil might make it harder to empty your bladder. Call your healthcare provider right away if you cannot empty your bladder.
Skin Reaction (Transdermal Patches). Donepezil transdermal patches may cause a skin reaction called allergic contact dermatitis where the patch was applied. Stop using donepezil transdermal patches and call your healthcare provider if you have any of the following symptoms and they do not get better within 2 days (48 hours) after removing the patch.
- Skin redness or swelling
- Peeling or blisters on your skin
- Symptoms spreading to the area of skin beyond your patch application site
Weight Loss. Donepezil oral tablets and orally disintegrating tablets may cause weight loss in some people. Talk to your healthcare provider if you notice any unexpected weight loss.
Warnings & Precautions
Who should not use donepezil?
Allergies to Ingredients. People who are allergic to any of the following should not use donepezil.
- Donepezil
- Aricept
- Adlarity
- Any other medicine known as piperidines
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific donepezil products they stock.
Allergic Contact Dermatitis. People who had a skin reaction called allergic contact dermatitis to Adlarity (donepezil) transdermal patches in the past should not use donepezil transdermal patches again
What should I know about donepezil before using it?
Do not use donepezil unless it has been prescribed to you by a healthcare provider. Use it as prescribed.
Do not share donepezil with other people, even if they have the same condition as you. It may harm them.
Keep donepezil out of the reach of children.
Donepezil 23 mg tablets should be swallowed whole. Do not chew, cut, or crush donepezil 23 mg tablets.
Donepezil orally disintegrating tablets melt on the tongue. You should drink some water after the tablet melts.
Since donepezil transdermal patches must be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.
Do not touch your eyes after you touch a donepezil patch. If you accidentally touch your eyes or your eyes get red after handling a patch, rinse your eyes with water right away. Get help from your healthcare provider if your symptoms do not go away on their own. In case of accidental contact with your eyes, or if your eyes become red after handling the patch, rinse your eyes right away with water and get emergency medical help if your symptoms do not go away.
If you are prescribed donepezil transdermal patches, avoid exposure to heat sources for long periods of time. Examples of heat sources include excessive sunlight, saunas, sunrooms, or heating pads. Heat exposure could make too much medicine be absorbed into your body.
Apply one donepezil patch at a time to your skin one time weekly, or every 7 days. Apply the patch to a place on your skin that is clean, dry, intact, and has little to no hair. If your donepezil patch falls off, apply a new patch right away, and remove it 7 days later.
What should I tell my healthcare provider before using donepezil?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if donepezil is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Heart problems, including irregular, slow, or fast heartbeat
- Lung problems, including asthma or obstructive pulmonary disease
- Seizures
- Stomach ulcers
- Difficulty passing urine
- Liver problems
- Kidney problems
- Trouble swallowing tablets
- Planned surgery, medical procedures, or dental surgery or procedures
Pregnancy. It is not known if or how donepezil could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.
Breastfeeding. It is not known if donepezil passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use donepezil while breastfeeding.
Interactions
Does donepezil interact with foods or drinks?
There are no known interactions between donepezil and foods or drinks.
It is unknown if drinking alcohol will affect donepezil. The risk of tiredness may be increased if you drink alcohol while using donepezil.
Does donepezil interact with other medicines (drug interactions)?
Donepezil interacts with many other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before using donepezil.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
- Anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
- Anesthesia given to you by your healthcare provider during surgery, medical procedures, or dental procedures
- A type of medicine called a cholinergic, which includes bethanechol (which may be used for urinary retention), and certain other medicines commonly used for dry mouth, dry eyes, and glaucoma
This may not be a complete list of medicines that can interact with donepezil. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much donepezil?
If you or someone else has used too much donepezil, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of donepezil?
Oral Tablet and Orally Disintegrating Tablet. If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses. If you miss 7 days or more, talk to your healthcare provider before starting again.
Transdermal Patch. If the patch falls off, or if you miss a dose, apply a new patch right away, and remove it 7 days later. Do not apply double or extra patches. If you stop using donepezil patches, talk to your healthcare provider for instructions before starting again.
Are you currently using Donepezil?
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