Donepezil helps ease the symptoms of dementia in Alzheimer's disease.
Take one dose a day, at bedtime.Your doctor will want to check on your progress regularly, so try to remember to keep your clinic appointments.
|Type of medicine||An anti-dementia medicine (an acetylcholinesterase inhibitor)|
|Used for||Symptoms of dementia associated with Alzheimer's disease|
|Available as||Tablets, orodispersible tablets (these melt in the mouth), and liquid medicine (oral solution)|
Donepezil is prescribed for people who have dementia which is associated with Alzheimer's disease. Dementia is a condition of the brain which causes a gradual loss of mental ability. This includes problems with memory, understanding, judgement, thinking and language. Other problems also commonly develop, such as changes in personality and changes in the way a person interacts with others in social situations.
Donepezil is not a cure for dementia, but it can help with symptoms, particularly those which affect thinking and memory. It works by increasing the level of a natural chemical called acetylcholine. This is a chemical which allows nerve cells in the brain to communicate with each other, and it is known that people with dementia have low levels of it.
Donepezil will be prescribed by a doctor who is a specialist. If you are a caregiver, please read this leaflet on behalf of the person who is receiving donepezil.
Before taking donepezil
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking donepezil it is important that your doctor knows:
- If you have a heart condition, such as an irregular heartbeat.
- If you have any problems with your breathing, such as asthma or chronic obstructive pulmonary disease (COPD).
- If you have any problems with the way your liver works.
- If you have ever had any of the following: a stomach ulcer, a fit (seizure), or any problems passing urine.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take donepezil
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about donepezil, and it will also provide you with a full list of the side-effects which you could experience from taking it.
- Your caregiver will help you to take your tablets/medicine exactly as your doctor tells you to. Take one dose every day just before bedtime. It is usual to be prescribed 5 mg daily to take initially, although your dose could be increased to 10 mg daily after the first month. Donepezil can be taken either with or without food.
- If you have been given the tablets that melt in the mouth (a brand of tablet called Aricept Evess®), place the tablet on your tongue and allow it to disintegrate in your mouth before you swallow. You may find it helps to have a drink of water afterwards.
- If you have been supplied with donepezil liquid medicine (1 mg/ml), you will also be given a dosing spoon with which to measure out your doses. If you are taking a 5 mg dose, fill the spoon to the 5 ml line; if you are taking a 10 mg dose, fill the spoon to the 10 ml line.
- If you forget to take a dose, do not worry, just take your dose on the following day as normal. Do not take two doses together to make up for the forgotten dose. If you forget to take donepezil for more than a week, talk with your doctor before you start to take it again, as you may need to re-start your treatment on a lower dose.
Getting the most from your treatment
- It can take a few weeks before you feel the full benefit of donepezil. Continue to take your doses every day until you are told otherwise by your doctor. Medicines for dementia are usually continued for as long as they are thought to be having a worthwhile effect on symptoms.
- Your doctor will want to check your progress every few weeks to make sure that you are getting benefit from the treatment. Always try to keep these regular doctor's appointments.
- Your doctor is likely to advise you not to drink alcohol while you are on this medicine. Drinking alcohol with donepezil can reduce its effectiveness.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking donepezil. This is particularly important if you are going to need a general anaesthetic.
- If you buy or take any 'over-the-counter' medicines, always check with a pharmacist that they are safe to take with your prescribed medicines. Some medicines can interfere with the way donepezil works.
Can donepezil cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with donepezil. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer's printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common donepezil side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick||Stick to simple foods - avoid fatty or spicy meals|
|Diarrhoea||Drink plenty of water to replace any lost fluids|
|Headache||Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headache continues, speak with your doctor|
|Common donepezil side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Being sick, loss of appetite, tummy (abdominal) discomfort||Stick to simple foods - avoid fatty or spicy meals|
|Feeling dizzy, faint, or tired||Be especially carefully if you are using any tools or machines|
|Sleeping problems, common colds, feeling agitated or aggressive, muscle cramps, hallucinations (seeing or hearing things that are not really there), itchy rash, and urine incontinence||If any of these become troublesome, speak with your doctor|
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
How to store donepezil
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Once a bottle of donepezil oral solution has been opened, it will keep for two months - after this time, make sure you have a fresh supply.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Aricept® tablets; Eisai Ltd, The electronic Medicines Compendium. Dated November 2016.
- Manufacturer's PIL, Aricept Evess®; Eisai Ltd, The electronic Medicines Compendium. Dated November 2016.
- Manufacturer's PIL, Donepezil Hydrochloride 1 mg/1 ml Oral Solution; Rosemont Pharmaceuticals Limited, The electronic Medicines Compendium. Dated January 2016.
- British National Formulary; 72nd Edition (Sep 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall