Aricept Fact Sheet
Medication Name (brand):
Aricept
Medication Name (clinical):
donepezil
Manufacturer:
Esai and Pfizer; patent expires 2010.
Indications:
Mild to moderate Alzheimer’s dementia.
- Moderate to severe Alzheimer's dementia.
- Off-label use for mild cognitive impairment.
Mechanism:
Acetylcholinesterase inhibitor. Enhances brain cholinergic function.
Dosing:
Supplied as:
- 5 mg white and 10 mg yellow tablets
- Orally disintegrating tablets: 5 mg white and 10 mg yellow.
- Start at 5 mg QD, increase to 10 mg QD after four weeks. Morning dosing may minimize insomnia and vivid dreams.
- No dose adjustment needed in renal impairment; only a minimal dose decrease required in hepatic impairment.
Side Effects:
Most common: nausea, diarrhea, insomnia, fatigue.
- Occasionally: agitation, vivid dreams.
- May aggravate stomach ulcers (potential class effect of all cholinesterase inhibitors)
- Pregnancy risk category C.
Drug-drug Interactions:
Partly metabolized by P450 3A4, so theoretically levels could be increased by 3A4 inhibitors such as Luvox, and levels could be decreased by inducers such as Tegretol.
Pharmokinetics:
Metabolized mostly by liver; about 20% is excreted unchanged in the urine.
- Half-life 3 days.
Pearls:
Aricept has the best evidence for effectiveness in mild cognitive impairment of all cholinesterase inhibitors.
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